Provider Demographics
NPI:1275613309
Name:DANGES, ROBERT F (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:DANGES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX A9
Mailing Address - Street 2:SUMMIT ROAD
Mailing Address - City:SWIFTWATER
Mailing Address - State:PA
Mailing Address - Zip Code:18370-9730
Mailing Address - Country:US
Mailing Address - Phone:570-839-9196
Mailing Address - Fax:
Practice Address - Street 1:206 E BROWN ST
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3006
Practice Address - Country:US
Practice Address - Phone:570-420-5331
Practice Address - Fax:570-422-8233
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003206L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP05478Medicare UPIN
082495R15Medicare ID - Type Unspecified