Individual
MISS CHRISTINA DIANA MANDERBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
2118 COTTMAN AVE, PHILADELPHIA, PA 19149-1133
(215) 342-3020
(215) 342-3653
Mailing address
2450 W HUNTING PARK AVE, 2ND FLOOR TPI, PHILADELPHIA, PA 19129-1302
(215) 926-9022
(215) 226-8286
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA054232
PA
Other
Enumeration date
12/08/2009
Last updated
04/24/2017
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