Healthcare Provider Details

I. General information

NPI: 1942581889
Provider Name (Legal Business Name): CHRISTINA INTESO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2011
Last Update Date: 01/05/2021
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10685 CARNEGIE AVE X20
CLEVELAND OH
44195-1069
US

IV. Provider business mailing address

10685 CARNEGIE AVE # X20
CLEVELAND OH
44106-3018
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-8422
  • Fax:
Mailing address:
  • Phone: 216-444-8422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03439851
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: