Provider Demographics
NPI:1306198239
Name:DALE, ROBERT E (PA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:DALE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2151 SHENANGO VALLEY FWY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2586
Mailing Address - Country:US
Mailing Address - Phone:724-981-2522
Mailing Address - Fax:724-981-5974
Practice Address - Street 1:2151 SHENANGO VALLEY FWY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2586
Practice Address - Country:US
Practice Address - Phone:724-981-2522
Practice Address - Fax:724-981-5974
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA055732363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant