Provider Demographics
NPI:1679668263
Name:JANN, ROBERT JOSEPH SR (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:JANN
Suffix:SR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BAILEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1007
Mailing Address - Country:US
Mailing Address - Phone:215-378-0471
Mailing Address - Fax:
Practice Address - Street 1:6 PENNS TRL
Practice Address - Street 2:SUITE 216
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1889
Practice Address - Country:US
Practice Address - Phone:215-348-0471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004443L103T00000X, 103TC0700X
NJ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool