Provider Demographics
NPI:1679569420
Name:CHAEFSKY, ROBERT LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LOUIS
Last Name:CHAEFSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:704 RAMBLER RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1217
Mailing Address - Country:US
Mailing Address - Phone:215-635-5602
Mailing Address - Fax:215-752-7333
Practice Address - Street 1:3237 BRISTOL RD
Practice Address - Street 2:#206
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2132
Practice Address - Country:US
Practice Address - Phone:215-752-9735
Practice Address - Fax:215-752-7333
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009557E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CHO19240Medicare ID - Type Unspecified