Healthcare Provider Details

I. General information

NPI: 1316092158
Provider Name (Legal Business Name): ROBERT J. DIGIACOMO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W CHESTER PIKE SUITE D2
WEST CHESTER PA
19382-7778
US

IV. Provider business mailing address

1515 W CHESTER PIKE SUITE D2
WEST CHESTER PA
19382-7778
US

V. Phone/Fax

Practice location:
  • Phone: 619-692-2092
  • Fax: 619-692-2863
Mailing address:
  • Phone: 619-692-2092
  • Fax: 619-692-2863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS003402-L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS003402-L
License Number StatePA

VIII. Authorized Official

Name: ROBERT J. DIGIACOMO
Title or Position: PSYCHOLOGIST
Credential: M.A.
Phone: 610-692-2092