Provider Demographics
NPI:1174596613
Name:JAMBRO, ROBERT D (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:JAMBRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:172 MIDDLETOWN BLVD STE 203
Mailing Address - Street 2:POST OFFICE BOX L-#305
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1871
Mailing Address - Country:US
Mailing Address - Phone:215-752-4848
Mailing Address - Fax:215-741-1498
Practice Address - Street 1:172 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE #203
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1871
Practice Address - Country:US
Practice Address - Phone:215-752-4848
Practice Address - Fax:215-741-1498
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-014022E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000178511Medicare ID - Type Unspecified
PAB40747Medicare UPIN