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General NPI Number Information
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NPI Number | 1114138609
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Entity Type | Organization
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Legal Business Name | CHITO M. CRUDO, M.D., P.C.
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 25 FAYETTE STREET
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City | BELLE VERNON
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State | PA
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Zip | 15012-1666
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Country | US
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Telephone | 724-929-4122
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Fax | 724-929-5188
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Provider Business Mailing Address
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Address Line | PO BOX 251
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City | BELLE VERNON
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State | PA
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Zip | 15012-0251
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Country | US
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Telephone | 724-929-5188
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHITO M CRUDO
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Credential | MD
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Telephone | 724-929-4122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD035941L
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License Number State | PA
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