Healthcare Provider Details

I. General information

NPI: 1952633067
Provider Name (Legal Business Name): MARIA DEL CARMEN CIANCHINI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB APOLO CALLE GEA QQ9
GUAYNABO PUERTO RICO
00969
UM

IV. Provider business mailing address

URB APOLO CALLE GEA QQ9
GUAYNABO PUERTO RICO
00969
UM

V. Phone/Fax

Practice location:
  • Phone: 787-789-6604
  • Fax:
Mailing address:
  • Phone: 787-789-6604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number393
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: