Provider Demographics
NPI:1639376262
Name:KRAVIS, ROBERT A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:KRAVIS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8302 OLD YORK RD
Mailing Address - Street 2:SUITE B7
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1522
Mailing Address - Country:US
Mailing Address - Phone:215-572-1117
Mailing Address - Fax:
Practice Address - Street 1:8302 OLD YORK RD
Practice Address - Street 2:SUITE B7
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1522
Practice Address - Country:US
Practice Address - Phone:215-572-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 002583 L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist