Individual
MARIO A CRISTANCHO PIMIENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 MARKET STREET, 3RD FLOOR, PHILADELPHIA, PA 19104-3309
(215) 746-6700
(215) 746-5155
Mailing address
3535 MARKET STREET, 3RD FLOOR, PHILADELPHIA, PA 19104-3309
(215) 746-6700
(215) 746-5155
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD443666
PA
2084P0800X
Psychiatry Physician
MT193855
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT193855
PA
Other
Enumeration date
07/11/2008
Last updated
06/05/2012
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