MISS CHRISTINA DIANA MANDERBAUGH (NPI# 1861721581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861721581 |
| Entity Type | Individual |
| Full Name | MISS CHRISTINA DIANA MANDERBAUGH |
| Credential | P.A.-C |
| Practice Address |
2118 Cottman Ave Philadelphia PA 19149-1133 |
| Mailing Address |
2450 W Hunting Park Ave 2nd Floor Tpi Philadelphia PA 19129-1302 |
| Practice Telephone | 2153423020 |
| Practice Fax Number | 2153423653 |
| Mailing Telephone | 2159269022 |
| Mailing Fax Number | 2152268286 |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2017-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA054232 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2118 COTTMAN AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19149-1133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750819538 | Matthew C Dudek | Family Medicine | 2118 Cottman Ave, Philadelphia, PA 19149-1133 | 2017-05-24 |
| 1750741674 | Swanna Luo | Physician Assistant | 2118 Cottman Ave, Philadelphia, PA 19149-1133 | 2016-03-04 |
| 1619350220 | Matthew Hassey | Optometrist | 2118 Cottman Ave, Philadelphia, PA 19149-1133 | 2015-06-30 |
| 1194105445 | Lisa Ashley Maguire | Family Medicine | 2118 Cottman Ave, Philadelphia, PA 19149 | 2015-06-02 |
| 1407254378 | Temple Physicians Inc | Clinic/Center | 2118 Cottman Ave, Philadelphia, PA 19149-1133 | 2014-12-09 |
| 1134474299 | Yasmin Vesamia | Optometrist | 2118 Cottman Ave, Philadelphia, PA 19149-1133 | 2012-07-16 |
| 1396000345 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 2118 Cottman Ave, #8, Philadelphia, PA 19149 | 2012-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508418948 | Double Care Inc | Clinic/Center | 2900-14 Cottman Ave, Philadelphia, PA 19149 | 2019-07-16 |
| 1710539457 | Xiao Rong Li | Adult Companion | 2900 - 14 Cottman Avenue, Philadelphia, PA 19149 | 2019-07-12 |
| 1154982775 | K Dental LLC | Clinic/Center | 6214 Bustleton Avenue, Philadelphia, PA 19149 | 2019-06-25 |
| 1851950430 | Halo Staffing Agency, LLC | Home Health | 6401 Akron St., Philadelphia, PA 19149 | 2019-06-07 |
| 1518450626 | Family First Home Healthcare LLC | In Home Supportive Care | 1405 Alcott St, Philadelphia, PA 19149 | 2018-06-13 |
| 1992106926 | Elena Semprevivo | Dentist | 2107 Cottman Avenue, Philadelphia, PA 19149 | 2014-09-09 |
| 1518366988 | Abundant Life Home Health Services | Home Health | 6632-46 Bustleton Ave, Philadelphia, PA 19149 | 2014-08-21 |
| 1598189771 | Citywide Community Counseling Services | Clinic/Center | 1346 Knorr St, Philadelphia, PA 19149 | 2014-02-10 |
| 1114341328 | Citywide Community Counseling Services | Clinic/Center | 5807 Bustleton Avenue, Philadelphia, PA 19149 | 2014-02-07 |
| 1790115509 | Norman Huynh | Physical Therapist | 6595 B East Roosevelt Boulevard, Philadelphia, PA 19149 | 2013-11-14 |
| Find all providers in zip 19149 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283986 | Margaret Ann Malloy | Physician Assistant | 3223 N Broad St Fl 1, Philadelphia, PA 19140-5007 | 2020-10-20 |
| 1174122493 | Juliana Debnam | Physician Assistant | 235 S 15th St Apt 904, Philadelphia, PA 19102-5031 | 2020-10-19 |
| 1457950867 | Kyllington Spotts | Physician Assistant | 1151 N 3rd St Unit 301, Philadelphia, PA 19123-1578 | 2020-10-19 |
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1457977944 | Jiyean Yoo | Physician Assistant | 2929 Walnut St Apt 4424, Philadelphia, PA 19104-5096 | 2020-06-19 |
| 1356987747 | Jennifer Rose Cueni | Physician Assistant | 2120 Brandywine St, Philadelphia, PA 19130-3107 | 2019-11-21 |
| 1730740408 | Olivia Anne Leventry | Physician Assistant | 109 Fairmount Ave, Philadelphia, PA 19123-3004 | 2019-06-24 |
| 1588136055 | Jefferson University Physcians | Physician Assistant | 1020 Sansom St Fl 10, Philadelphia, PA 19107-5002 | 2018-12-21 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922589365 | Rachel Diane Simonsen | Physician Assistant | 1741 Frankford Ave Ste 100a, Philadelphia, PA 19125-2445 | 2018-08-23 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19149 |
Please comment or provide details below to improve the information on MISS CHRISTINA DIANA MANDERBAUGH.
| 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.