Provider Demographics
NPI:1003830423
Name:PIZZIKETTI, ROBERT JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:PIZZIKETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:76 ACCO DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4668
Mailing Address - Country:US
Mailing Address - Phone:717-852-7766
Mailing Address - Fax:717-852-7862
Practice Address - Street 1:810 BONNEVIEW RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2001
Practice Address - Country:US
Practice Address - Phone:717-852-7766
Practice Address - Fax:717-852-7862
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042127E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPI583063Medicare ID - Type Unspecified
PAE29929Medicare UPIN