Healthcare Provider Details

I. General information

NPI: 1487662219
Provider Name (Legal Business Name): ROBERT JOSEPH SASS D.O. FACOS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 EASTON RD
WILLOW GROVE PA
19090-1901
US

IV. Provider business mailing address

868 HOSTMAN AVE
WARMINSTER PA
18974-3058
US

V. Phone/Fax

Practice location:
  • Phone: 215-830-5400
  • Fax: 215-659-2655
Mailing address:
  • Phone: 267-431-0878
  • Fax: 888-435-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS006544L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS006544L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS006544L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO1659
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: