Individual
THERESA MARIE CROCENELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
974 BEAVER GRADE RD, MOON TOWNSHIP, PA 15108-2746
(412) 264-6117
(412) 264-6159
Mailing address
974 BEAVER GRADE RD, MOON TOWNSHIP, PA 15108-2746
(412) 264-6117
(412) 264-6159
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD070629L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1807242
—
PA
Enumeration date
09/29/2005
Last updated
06/11/2013
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