Provider Demographics
NPI:1346289873
Name:MAURICIO-TAN, MARIVI SANCHEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIVI
Middle Name:SANCHEZ
Last Name:MAURICIO-TAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIVI
Other - Middle Name:SANCHEZ
Other - Last Name:MAURICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-2710
Mailing Address - Fax:717-339-2711
Practice Address - Street 1:40 V TWIN DR
Practice Address - Street 2:SUITE 202
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1926
Practice Address - Country:US
Practice Address - Phone:717-339-2710
Practice Address - Fax:717-339-2711
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0666692L2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry