Provider Demographics
NPI:1558686329
Name:WASSERMAN, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 SCHILLER AVE
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1020
Mailing Address - Country:US
Mailing Address - Phone:610-664-5749
Mailing Address - Fax:
Practice Address - Street 1:610 SCHILLER AVE
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1020
Practice Address - Country:US
Practice Address - Phone:610-664-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035239E2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology