Crocenelli, Theresa Marie

Crocenelli, Theresa Marie is an sole proprietor health care provider with primary practice located at 974 Beaver Grade Rd , Moon Township PA 15108-2746. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Crocenelli, Theresa Marie can be contacted via phone (412) 264-6117.

Contact Information

Primary practice address
974 Beaver Grade Rd Moon Township PA 15108-2746
Phone: (412) 264-6117
Fax: (412) 264-6159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD070629L Pennsylvania

Profile Details

NPI number 1023005618
LBN Legal business name Crocenelli, Theresa Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2005
Last updated Jun 11th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023005618 NPPES
Pennsylvania MEDICAID 1807242

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