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General NPI Number Information
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NPI Number | 1770648370
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Entity Type | Individual
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Provider Name | THOMAS J KRISANDA MD
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 5401 OLD COURT ROAD NORTHWEST HOSPITAL EMERGENCY DEPT.
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City | RANDALLSTOWN
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State | MD
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Zip | 21133
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Country | US
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Telephone | 410-521-5950
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Fax | 410-828-6004
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Provider Business Mailing Address
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Address Line | 5401 OLD COURT ROAD NORTHWEST HOSPITAL EMERGENCY DEPT.
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City | RANDALLSTOWN
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State | MD
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Zip | 21133
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Country | US
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Telephone | 410-521-5950
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Fax | 410-828-6004
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD043477E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD-043477-E
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | D0053345
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License Number State | MD
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