MEDICARE: DR. ROBERT P MARCINCIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	MD022104E	PA

General Provider Information

NPI Number	:	1629072996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT P MARCINCIN M.D.

Provider Business Mailing Address
First Line	:	35 E ELIZABETH AVE
Second Line	:	STE 38
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6505
Country	:	US
Telephone Number	:	610-866-2552
Fax Number	:	610-882-9932

Provider Business Practice Location Address
First Line	:	35 E ELIZABETH AVE
Second Line	:	STE 38
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6505
Country	:	US
Telephone Number	:	610-866-2552
Fax Number	:	610-882-9932

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/08/2007

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