Provider Demographics
NPI:1447259437
Name:FUCHS, BETTY ROBIN (MD)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:ROBIN
Last Name:FUCHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:BETSY
Other - Middle Name:ROBIN
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:713 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2490
Mailing Address - Country:US
Mailing Address - Phone:518-213-0410
Mailing Address - Fax:518-640-9107
Practice Address - Street 1:713 TROY SCHENECTADY RD
Practice Address - Street 2:SUITE 218
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2490
Practice Address - Country:US
Practice Address - Phone:518-213-0410
Practice Address - Fax:518-640-9107
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170443207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01058795Medicaid
NY10000709OtherCDPHP
NY36116OtherMVP
NYP00229098OtherRAILROAD MEDICARE
NY000417015002OtherBLUE SHIELD
NY36116OtherMVP
NY01058795Medicaid