Healthcare Provider Details

I. General information

NPI: 1619610722
Provider Name (Legal Business Name): CHRISTINE FRANCIS MARTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S 5TH AVE
WEST READING PA
19611-2143
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 484-369-0812
  • Fax:
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD494548
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: