Provider Demographics
NPI:1851354963
Name:IRWIN, ROBERT E (OTR/L)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:IRWIN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6998 CRIDER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-2390
Mailing Address - Country:US
Mailing Address - Phone:724-778-3311
Mailing Address - Fax:724-779-3313
Practice Address - Street 1:6998 CRIDER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-2390
Practice Address - Country:US
Practice Address - Phone:724-778-3311
Practice Address - Fax:724-779-3313
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001327L225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA852850OtherBLUE CROSS/BLUE SHIELD
PA852850OtherBLUE CROSS/BLUE SHIELD
PA078688JMYMedicare ID - Type Unspecified