Provider Demographics
NPI:1710995527
Name:TRUTIA, CRISTINA ANDREEA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:ANDREEA
Last Name:TRUTIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 US OVAL
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12903-5900
Mailing Address - Country:US
Mailing Address - Phone:518-324-4803
Mailing Address - Fax:518-324-4803
Practice Address - Street 1:22 US OVAL
Practice Address - Street 2:SUITE 207
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12903-5900
Practice Address - Country:US
Practice Address - Phone:518-324-4802
Practice Address - Fax:518-324-4817
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2313762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02568252Medicaid
NY02568252Medicaid