Provider Demographics
NPI:1487662219
Name:SASS, ROBERT JOSEPH (DO FACOS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:SASS
Suffix:
Gender:M
Credentials:DO FACOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 HOSTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3058
Mailing Address - Country:US
Mailing Address - Phone:267-431-0878
Mailing Address - Fax:888-435-2088
Practice Address - Street 1:1113 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1901
Practice Address - Country:US
Practice Address - Phone:215-830-5400
Practice Address - Fax:215-659-2655
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006544L207QG0300X, 208600000X, 208D00000X
TNDO1659207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010021049Medicaid
VA180853OtherBCBS LSA- MARION
P00090770OtherRAILROAD MEDICARE
VA010190819Medicaid
VA5764450OtherAETNA
VA102099OtherLSA- LEBANON
VA010021049Medicaid
VA180853OtherBCBS LSA- MARION
VA102099OtherLSA- LEBANON