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General NPI Number Information
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NPI Number | 1073694287
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Entity Type | Organization
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Legal Business Name | JOSEPH A DICRISTOFARO
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 100 NEW HOPE RD MEDICAL ARTS BUILDING SUITE #12
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City | PRINCETON
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State | WV
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Zip | 24740
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Country | US
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Telephone | 304-487-3160
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Fax | 304-487-3455
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Provider Business Mailing Address
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Address Line | 100 NEW HOPE RD MEDICAL ARTS BUILDING SUITE #12
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City | PRINCETON
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State | WV
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Zip | 24740
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Country | US
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Telephone | 304-487-3160
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Fax | 304-487-3455
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH ANTHONY DICRISTOFARO
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Credential | RT. , CMNT
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Telephone | 304-487-3160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471N0900X
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Taxonomy Name | Nuclear Medicine Technology Radiologic Technologist
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License Number |
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License Number State |
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