Provider Demographics
NPI:1174002323
Name:KALITINA, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:KALITINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 BELLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1309
Mailing Address - Country:US
Mailing Address - Phone:215-303-6643
Mailing Address - Fax:
Practice Address - Street 1:2718 BELLVIEW DR
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1309
Practice Address - Country:US
Practice Address - Phone:215-303-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator