Provider Demographics
NPI:1104120427
Name:SAVITSKI, ROBERT A
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:SAVITSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:E
Other - Last Name:SAVITSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:217 OAK AVE SW
Mailing Address - Street 2:NA
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-9771
Mailing Address - Country:US
Mailing Address - Phone:763-497-3043
Mailing Address - Fax:
Practice Address - Street 1:217 OAK AVE SW
Practice Address - Street 2:NA
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-9771
Practice Address - Country:US
Practice Address - Phone:763-497-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1041020385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care