Provider Demographics
NPI:1417544701
Name:ESGRO, ROBERT (RPH, ESQ)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:ESGRO
Suffix:
Gender:M
Credentials:RPH, ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ALDWYN LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1421
Mailing Address - Country:US
Mailing Address - Phone:610-308-6666
Mailing Address - Fax:
Practice Address - Street 1:46 ALDWYN LN
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1421
Practice Address - Country:US
Practice Address - Phone:610-308-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02716600183500000X
DEA1-0003008183500000X
PARP037397L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist