Provider Demographics
NPI:1316092158
Name:ROBERT J. DIGIACOMO, INC.
Entity type:Organization
Organization Name:ROBERT J. DIGIACOMO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIGIACOMO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:610-692-2092
Mailing Address - Street 1:1515 W CHESTER PIKE
Mailing Address - Street 2:SUITE D2
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7778
Mailing Address - Country:US
Mailing Address - Phone:619-692-2092
Mailing Address - Fax:619-692-2863
Practice Address - Street 1:1515 W CHESTER PIKE
Practice Address - Street 2:SUITE D2
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7778
Practice Address - Country:US
Practice Address - Phone:619-692-2092
Practice Address - Fax:619-692-2863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003402-L103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty