Healthcare Provider Details

I. General information

NPI: 1992793236
Provider Name (Legal Business Name): SANDRA ANN CROMO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CORPORATE DR SUITE 200
WEXFORD PA
15090-7645
US

IV. Provider business mailing address

200 LOTHROP ST FORBES TOWER, SUITE 9055
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 724-933-3400
  • Fax: 724-933-3455
Mailing address:
  • Phone: 412-647-8384
  • Fax: 412-647-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD041857L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: