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General NPI Number Information
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NPI Number | 1043877897
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Entity Type | Individual
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Provider Name | SANDI PINO MSN, CRNP, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 2250 HICKORY RD STE 140
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1047
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Country | US
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Telephone | 610-379-2904
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Fax | 610-840-0528
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Provider Business Mailing Address
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Address Line | PO BOX 37492
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City | BELFAST
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State | ME
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Zip | 04915-1216
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Country | US
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Telephone | 610-379-2904
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Fax | 610-840-0528
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP020359
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP020359
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP020359
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License Number State | PA
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