Provider Demographics
NPI:1932188307
Name:CRISTEA, SORINA V (PA-AA)
Entity Type:Individual
Prefix:
First Name:SORINA
Middle Name:V
Last Name:CRISTEA
Suffix:
Gender:F
Credentials:PA-AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 DENMEAD ML SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5176
Mailing Address - Country:US
Mailing Address - Phone:678-429-0808
Mailing Address - Fax:
Practice Address - Street 1:1968 PEACHTREE RD., NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-351-1745
Practice Address - Fax:404-351-7121
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002720367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA369746582DMedicaid
GAP00322882Medicare PIN
GAS26352Medicare UPIN
GA369746582BMedicaid
GA511I320014Medicare PIN
GA369746582AMedicaid