Active NPI
Robert Charles Walkow, PSYCHOLOGIST
- Psychologist
- Erie, PA
National Provider Identifier
1356476485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS003974L
- Practice address
- 3702 Bon View Drive
Erie, PA 16506-2258 - Phone
- (814) 838-4706
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS003974L | PA | Primary |
Addresses
Primary practice location
3702 Bon View Drive
Erie, PA 16506-2258
Mailing address
3702 Bon View Drive
Erie, PA 16506-2258
Phone (814) 838-4706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01934773 | Other | PA | DEPARTMENT OF PUBLIC WELF |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS003974L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356476485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3702 BON VIEW DRIVE",
"city": "ERIE",
"state": "PA",
"postal_code": "165062258",
"telephone_number": "814-838-4706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3702 BON VIEW DRIVE",
"city": "ERIE",
"state": "PA",
"postal_code": "165062258",
"telephone_number": "814-838-4706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKOW",
"first_name": "ROBERT",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS003974L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF PUBLIC WELF",
"identifier": "01934773",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.