| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Robert Vandercook · Robert Vandercook Psy | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Robert | [sources] | |||
| ID Number | PROMISe# 103276703 · PS016986 | [sources] | |||
| Last name | Vandercook | [sources] | |||
| NPI | 1225329493 | [sources] | |||
| Sector | 103TC0700X, 103T00000X,10 1Y00000X- 2084P0800X- 2084P0802X | [sources] | |||
| Title | Psy. D. | [sources] | |||
| Address | out of state, PA | [sources] | |||
| Last change | Last processed | First seen | |||
List of providers excluded from participating in the Delaware Medicaid program.
United States · DHSS
Medical providers who are precluded from participation in the Medical Assistance Program
United States · DHS
us-medde-33ed989c001dcba3d9a6cb33dee573c74a98dd06 · us-medpa-ff130ea2930a510d292c79ea5a444577244af93dFor experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Pennsylvania Department of Human services | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| Out of state, PA · Out-of-State, PA · out of state, PA | United States | |
| United States | Department of Human Services | - | - |