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General NPI Number Information
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NPI Number | 1841494572
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Entity Type | Individual
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Provider Name | CHRISTINA MARIE PERUTO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 925 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4216
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Country | US
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Telephone | 267-339-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 LOCUST ST APT 2911
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4322
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Country | US
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Telephone |
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Fax |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MT188890
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License Number State | PA
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