Provider Demographics
NPI:1982675401
Name:CONCINI, ROBERT J (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:CONCINI
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4100 BEAR CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAR CREEK TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18702-9717
Mailing Address - Country:US
Mailing Address - Phone:570-709-7048
Mailing Address - Fax:
Practice Address - Street 1:225 PENN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1921
Practice Address - Country:US
Practice Address - Phone:570-342-7864
Practice Address - Fax:570-342-7119
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2021-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051003363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical