Provider Demographics
NPI:1417199498
Name:BARTIROMO, KRISTINA (PT, DPT, MED, A PRF)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:BARTIROMO
Suffix:
Gender:F
Credentials:PT, DPT, MED, A PRF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 EISENHOWER DR BLDG 1400
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1600
Mailing Address - Country:US
Mailing Address - Phone:912-401-0443
Mailing Address - Fax:912-401-0444
Practice Address - Street 1:340 EISENHOWER DR BLDG 1400
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1600
Practice Address - Country:US
Practice Address - Phone:912-401-0443
Practice Address - Fax:912-401-0444
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005067174400000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No172V00000XOther Service ProvidersCommunity Health Worker