Provider Demographics
NPI:1639131030
Name:YELLENIK, ROBERT F (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:YELLENIK
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 1:27 HECKEL RD
Mailing Address - Street 2:STE 112
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1616
Mailing Address - Country:US
Mailing Address - Phone:412-777-4380
Mailing Address - Fax:412-777-4385
Practice Address - Street 1:27 HECKEL RD
Practice Address - Street 2:STE 112
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1616
Practice Address - Country:US
Practice Address - Phone:412-777-4380
Practice Address - Fax:412-777-4385
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039756L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA252809OtherUPMC
PA60685OtherUNISON
PAP000282OtherGATEWAY
PA0012863970014Medicaid
PA153401OtherHEALTH AMERICA
PA4516237OtherAETNA
PA0012863970014Medicaid
PA172787Medicare ID - Type UnspecifiedMEDICARE