MEDICARE: DR. SANDRA MILENA PINZON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MT192057	PA
2	2084N0400X	Neurology Physician	MD444580	PA

General Provider Information

NPI Number	:	1073774139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA MILENA PINZON M.D.

Provider Business Mailing Address
First Line	:	4820 PALOMINO CT
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16506-6624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 W STATE ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-1248
Country	:	US
Telephone Number	:	724-656-4037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2008
Last Update Date	:	09/14/2022

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