Provider Demographics
NPI:1174547079
Name:SIROTA, ROBERT A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:SIROTA
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 1:1261 ROUTE 38
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2702
Mailing Address - Country:US
Mailing Address - Phone:856-222-1975
Mailing Address - Fax:856-222-0721
Practice Address - Street 1:1261 ROUTE 38
Practice Address - Street 2:SUITE A
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2702
Practice Address - Country:US
Practice Address - Phone:856-222-1975
Practice Address - Fax:856-222-0721
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022066E207RN0300X
NJ25MA09461300207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02334MD022066EOtherHEALTH PARTNERS
NJ0490482Medicaid
PA096081OtherHIGHMARK BLUE SHIELD
PA0284284OtherCIGNA
PA096083OtherHIGHMARK
PA0069877002OtherAMERI CHOICE
PA0048674000OtherIBC
PA390003999OtherRAILROAD MEDICARE
PA1030006OtherKEYSTONE MERCY
PA4089601OtherAETNA
PA0006987700003Medicaid
PA0048674000OtherIBC
PAC29803Medicare UPIN