Healthcare Provider Details

I. General information

NPI: 1720829625
Provider Name (Legal Business Name): CHRISTINA GIORGIO BLUESTEIN PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SAINT PAUL ST
BALTIMORE MD
21202-2165
US

IV. Provider business mailing address

345 SAINT PAUL ST
BALTIMORE MD
21202-2123
US

V. Phone/Fax

Practice location:
  • Phone: 410-951-7950
  • Fax:
Mailing address:
  • Phone: 410-951-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number07104
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: