MEDICARE: MS. CHRISTINE MARIE SANTORO CPM, LM

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	176B00000X	Midwife	25MW00000400	NJ

General Provider Information

NPI Number	:	1659412500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE MARIE SANTORO CPM, LM

Provider Business Mailing Address
First Line	:	1809 S 16TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-2202
Country	:	US
Telephone Number	:	215-462-4784
Fax Number	:	215-462-4785

Provider Business Practice Location Address
First Line	:	1809 S 16TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-2202
Country	:	US
Telephone Number	:	215-462-4784
Fax Number	:	215-462-4785

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	01/06/2015

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