Provider Demographics
NPI:1548356751
Name:COBBS, WINSTON HB JR (MD, FCCP)
Entity type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:HB
Last Name:COBBS
Suffix:JR
Gender:M
Credentials:MD, FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 DUTCH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4246
Mailing Address - Country:US
Mailing Address - Phone:516-775-2184
Mailing Address - Fax:
Practice Address - Street 1:1800 DUTCH BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4246
Practice Address - Country:US
Practice Address - Phone:516-775-2184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150250207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00868415Medicaid
NY431821NAOtherCIGNA
NY9280OtherVYTRA PULMONARY SPEC
DS543OtherOXFORD
3C0611003OtherHEALTHNET
NY1000015401OtherAFFINITY HEALTH
163991OtherELDER PLAN
NY41112000126OtherFIDELIS CARE SPEC
NY75792OtherVYTRA PCP
HMO0101150OtherAETNA
0027600OtherGHI
NY040426008458OtherFIDELIS CARE PCP
0J072POtherHIP
3C0611003OtherHEALTHNET
0J072POtherHIP