Provider Demographics
NPI:1104871300
Name:DEIN, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:DEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:1030 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:ROSEMONT
Practice Address - State:PA
Practice Address - Zip Code:19010-1451
Practice Address - Country:US
Practice Address - Phone:610-525-3225
Practice Address - Fax:610-525-4932
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032079E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0075071000OtherKEYSTONE HPE
PA56919OtherHIGHMARK B/C B/S
PA056919TGWMedicare ID - Type Unspecified
PA0075071000OtherKEYSTONE HPE