Healthcare Provider Details

I. General information

NPI: 1205921236
Provider Name (Legal Business Name): LINDIA A PISTONE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3901
US

IV. Provider business mailing address

816 SAPLING CT
BEL AIR MD
21015-6411
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-9696
  • Fax:
Mailing address:
  • Phone: 410-905-5218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0002354
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: