Provider Demographics
NPI:1669437018
Name:ROBERT T SATALOFF, MD AND ASSOC, LLC
Entity type:Organization
Organization Name:ROBERT T SATALOFF, MD AND ASSOC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:THAYER
Authorized Official - Last Name:SATALOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-762-5530
Mailing Address - Street 1:219 N. BROAD STREET
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1506
Mailing Address - Country:US
Mailing Address - Phone:215-762-5530
Mailing Address - Fax:215-762-5540
Practice Address - Street 1:219 N. BROAD STREET
Practice Address - Street 2:10TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1506
Practice Address - Country:US
Practice Address - Phone:215-762-5530
Practice Address - Fax:215-762-5540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT T. SATALOFF, MD & ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-19
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101397352Medicaid
PA101397352Medicaid