Individual
CRISTIN SAMANTHA HAGELSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
154 EXTON SQUARE MALL, NEMOURS DUPONT PEDIATRICS, EXTON, EXTON, PA 19341-2440
(484) 565-8507
(610) 280-1531
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD446432
PA
208D00000X
General Practice Physician
Primary
MD446432
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-2359401
MAIN LINE HEALTHCARE TAX ID
PA
Enumeration date
05/05/2009
Last updated
12/09/2015
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