Provider Demographics
NPI:1780866137
Name:JEFFREYS, ROBERT F JR (SLP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:JEFFREYS
Suffix:JR
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 SIEMON DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-7055
Mailing Address - Country:US
Mailing Address - Phone:814-444-1236
Mailing Address - Fax:814-444-1236
Practice Address - Street 1:228 SIEMON DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-7055
Practice Address - Country:US
Practice Address - Phone:814-444-1236
Practice Address - Fax:814-444-1236
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005934L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA148576OtherHIGHMARK BC BS