Provider Demographics
NPI:1710978507
Name:BARON, ROBYN J (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:J
Last Name:BARON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E LANCASTER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2105
Mailing Address - Country:US
Mailing Address - Phone:484-565-1293
Mailing Address - Fax:484-476-7855
Practice Address - Street 1:306 E LANCASTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2105
Practice Address - Country:US
Practice Address - Phone:484-565-1293
Practice Address - Fax:484-476-7855
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009720L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017884140003Medicaid
PACD4869OtherTPI RR MEDICARE GROUP
PA597586OtherTPI MEDICAR GROUP
PA597586OtherTPI MEDICAR GROUP
PA0017884140003Medicaid
PACD4869OtherTPI RR MEDICARE GROUP