Provider Demographics
NPI:1295302883
Name:DISILVESTRO, CHRISTOPHER J (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:DISILVESTRO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4916
Mailing Address - Country:US
Mailing Address - Phone:267-366-8023
Mailing Address - Fax:
Practice Address - Street 1:2915 S 15TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4916
Practice Address - Country:US
Practice Address - Phone:267-366-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043356L1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care