Provider Demographics
NPI:1205164365
Name:CVITANOV, ROBIN (PT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:CVITANOV
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:FLECKENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:116 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-484-6232
Mailing Address - Fax:833-690-7898
Practice Address - Street 1:116 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-484-6232
Practice Address - Fax:833-690-7898
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018753225100000X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist