Provider Demographics
NPI:1043376130
Name:ANGELO, ROBERT JOSEPH (SPEECH THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:ANGELO
Suffix:
Gender:M
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 ELM ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-1432
Mailing Address - Country:US
Mailing Address - Phone:610-562-8564
Mailing Address - Fax:
Practice Address - Street 1:1 S HOME AVE
Practice Address - Street 2:
Practice Address - City:TOPTON
Practice Address - State:PA
Practice Address - Zip Code:19562-1317
Practice Address - Country:US
Practice Address - Phone:610-682-1427
Practice Address - Fax:610-682-1123
Is Sole Proprietor?:No
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000206L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist