Healthcare Provider Details

I. General information

NPI: 1083356539
Provider Name (Legal Business Name): CRISTINA SANTIAGO LOZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 MARKET ST
PHILADELPHIA PA
19104-3309
US

IV. Provider business mailing address

3535 MARKET ST
PHILADELPHIA PA
19104-3309
US

V. Phone/Fax

Practice location:
  • Phone: 215-746-7248
  • Fax:
Mailing address:
  • Phone: 787-641-6582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT238108
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: