MEDICARE: DR. DOLORES MARIE SARNO KRISTOFITS PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS003065L	PA

General Provider Information

NPI Number	:	1588662043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOLORES MARIE SARNO KRISTOFITS PHD

Provider Business Mailing Address
First Line	:	4949 LIBERTY LN
Second Line	:	SUITE 45
City	:	ALLENTOWN
State	:	PA
Zip	:	18106-9014
Country	:	US
Telephone Number	:	267-471-3620
Fax Number	:	215-249-0886

Provider Business Practice Location Address
First Line	:	4949 LIBERTY LN
Second Line	:	SUITE 45
City	:	ALLENTOWN
State	:	PA
Zip	:	18106-9014
Country	:	US
Telephone Number	:	267-471-3620
Fax Number	:	215-249-0886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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