DR. SEAN CHARLES DICRISTOFARO (NPI# 1053370056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053370056 |
| Entity Type | Individual |
| Full Name | DR. SEAN CHARLES DICRISTOFARO |
| Credential | M.D. |
| Practice Address |
104 Station Place Way Hurricane WV 25526-8747 |
| Practice Telephone | 3047577788 |
| Practice Fax Number | 3042011140 |
| Mailing Telephone | 3047577788 |
| Mailing Fax Number | 3042011140 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2007-11-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | WV19679 | WV | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 5630468000 | 05 |
| Street Address |
104 STATION PLACE WAY |
| City | HURRICANE |
| State | WV |
| Zip Code | 25526-8747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063663896 | Drm Inc | Social Worker | 104 Station Place Way, Hurricane, WV 25526-8747 | 2008-10-10 |
| 1548450174 | Appalachian Family Medicine Lab | Clinical Medical Laboratory | 104 Station Place Way, Hurricane, WV 25526-8747 | 2007-07-30 |
| 1093892127 | Appalachian Family Medicine | Specialist | 104 Station Place Way, Hurricane, WV 25526-8747 | 2006-11-01 |
| 1912099862 | Wendy G Etzkorn | Social Worker | 104 Station Place Way, Appalachian Family Medicine, Hurricane, WV 25526 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081707 | Paige E Walroth | Technician | 51 Overlook Dr, Hurricane, WV 25526 | 2020-10-21 |
| 1770195778 | Marilyn Sue Shank | Technician | 168 Willow Tree Way, Apt 313, Hurricane, WV 25526 | 2020-08-20 |
| 1275150351 | Wv Wellness and Recovery LLC | Clinic/Center | 4 Putnam Village Drive, Hurricane, WV 25526 | 2020-07-06 |
| 1538645718 | Patsy Samples | Technician | 3067 State Rt 34s, Hurricane, WV 25526 | 2018-07-11 |
| 1528550274 | Sarah Marie Jackson | Occupational Therapist | Genesis-putnam Center, 300 Seville Road, Hurricane, WV 25526 | 2018-05-30 |
| 1619466463 | Mh Psychological Services, Pllc | Psychologist | 125 Morris Ct, Hurricane, WV 25526 | 2018-05-08 |
| 1023510740 | William Riddle | Technician | 157 Washington Cirlce, Hurricane, WV 25526 | 2018-03-08 |
| 1942702303 | Natalie Whitman | Technician | 2933 State Route 34 South, Hurricane, WV 25526 | 2018-03-01 |
| 1972002681 | Dianna Roberts | Technician | 550 Dudding Avenue, Hurricane, WV 25526 | 2018-02-08 |
| 1174022875 | Nancy Adams | Technician | 1 Western Hills Drive, Hurricane, WV 25526 | 2018-02-08 |
| Find all providers in zip 25526 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255803920 | Premier Pediatrics LLC | Specialist | 48 S 2500 W Ste 220, Hurricane, UT 84737-3380 | 2018-12-19 |
| 1831471432 | Christine M Gorby | Specialist | 29 Poplar Hls, Hurricane, WV 25526-9103 | 2011-09-09 |
| 1770886749 | Emed Technologies & Billing LLC | Specialist | 101 Carriage Pt, Suite 103, Hurricane, WV 25526-1526 | 2010-12-14 |
| 1801038609 | Zina Beth Stewart | Specialist | 3534 Teays Valley Rd, Suite 3, Hurricane, WV 25526-9054 | 2009-03-25 |
| 1275088304 | Lesley Hutchison | Specialist | 101 Carriage Pt, Suite 202, Hurricane, WV 25526-1526 | 2016-08-18 |
| 1528513629 | Matthew Childress | Specialist | 101 Carriage Pt, Suite 202, Hurricane, WV 25526-1526 | 2016-08-18 |
| 1801243886 | Kayla Smith | Specialist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2016-05-19 |
| 1003174012 | Stephanie Renee Cole | Specialist | 3534 Teays Valley Rd, Hurricane, WV 25526-9054 | 2012-04-26 |
| 1518183508 | Katie Taylor Ethridge | Specialist | 179 Station Place Way, Suite 100, Hurricane, WV 25526-8747 | 2007-04-18 |
| 1649399882 | Brandi Daneen Frazier | Specialist | 590 Poplar Fork Rd, Hurricane, WV 25526-9434 | 2007-03-28 |
| Find all providers in HURRICANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.