Basic Information
| Provider Information | |||||||||
| NPI: | 1780778720 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALLADINO | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M ED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1204 HOLLY LANE | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108923800 | ||||||||
| FaxNumber: | 4844681412 | ||||||||
| Practice Location | |||||||||
| Address1: | 1204 HOLLY LN | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193429620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108923800 | ||||||||
| FaxNumber: | 4844681412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 01/27/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PS005852L | PA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.