Healthcare Provider Details

I. General information

NPI: 1346289873
Provider Name (Legal Business Name): MARIVI SANCHEZ MAURICIO-TAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIVI SANCHEZ MAURICO MD

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 V TWIN DR STE 202
GETTYSBURG PA
17325-7878
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-339-2710
  • Fax: 717-208-8455
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD0666692L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberMD0666692L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: