Provider Demographics
NPI:1659356996
Name:ROBERT D. MULTARI, D.O.,P.C.
Entity Type:Organization
Organization Name:ROBERT D. MULTARI, D.O.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MULTARI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-347-0861
Mailing Address - Street 1:PO BOX 1004
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-0004
Mailing Address - Country:US
Mailing Address - Phone:724-347-0861
Mailing Address - Fax:724-347-0864
Practice Address - Street 1:2120 LIKENS LN
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-2304
Practice Address - Country:US
Practice Address - Phone:724-981-3733
Practice Address - Fax:724-981-3740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003730L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00077048680005Medicaid
B36532Medicare UPIN
PA445113353Medicare PIN
PA00077048680005Medicaid