Provider Demographics
NPI:1659447415
Name:WASHEK, ROBERT (MA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:WASHEK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 RUSTIC LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-1633
Mailing Address - Country:US
Mailing Address - Phone:814-459-2755
Mailing Address - Fax:
Practice Address - Street 1:3035 RUSTIC LN
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-1633
Practice Address - Country:US
Practice Address - Phone:814-459-2755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005448L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018517600001Medicaid