Provider Demographics
NPI:1720025505
Name:ROBERT PEARSON DO PA
Entity Type:Organization
Organization Name:ROBERT PEARSON DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-262-0608
Mailing Address - Street 1:85 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1888
Mailing Address - Country:US
Mailing Address - Phone:201-262-0608
Mailing Address - Fax:201-262-8689
Practice Address - Street 1:85 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1888
Practice Address - Country:US
Practice Address - Phone:201-262-0608
Practice Address - Fax:201-262-8689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ186307Medicare PIN