Healthcare Provider Details

I. General information

NPI: 1144307620
Provider Name (Legal Business Name): ROBERT J. MARCOVITZ PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 BETHLEHEM PIKE
SPRING HOUSE PA
19477-0086
US

IV. Provider business mailing address

210 CLOVER LN
AMBLER PA
19002-2401
US

V. Phone/Fax

Practice location:
  • Phone: 215-646-5349
  • Fax:
Mailing address:
  • Phone: 215-646-5349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS002875L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS002875L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS002875L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier142602
Identifier TypeOTHER
Identifier StatePW
Identifier IssuerBLUE CROSS/ BLUE SHIELD
# 2
Identifier0004088155
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: