Provider Demographics
NPI:1104901883
Name:ECHENBERG, ROBERT JAY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAY
Last Name:ECHENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:623 W UNION BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-3708
Mailing Address - Country:US
Mailing Address - Phone:610-868-0104
Mailing Address - Fax:610-868-0204
Practice Address - Street 1:623 W UNION BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-3708
Practice Address - Country:US
Practice Address - Phone:610-868-0104
Practice Address - Fax:610-868-0204
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013092E207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology