Healthcare Provider Details

I. General information

NPI: 1710978507
Provider Name (Legal Business Name): ROBYN J BARON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 E LANCASTER AVE STE 200
WYNNEWOOD PA
19096-2105
US

IV. Provider business mailing address

306 E LANCASTER AVE STE 200
WYNNEWOOD PA
19096-2105
US

V. Phone/Fax

Practice location:
  • Phone: 484-565-1293
  • Fax: 484-476-7855
Mailing address:
  • Phone: 484-565-1293
  • Fax: 484-476-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS009720L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: