Provider Demographics
NPI:1982774188
Name:ESTEBAN-CRUCIANI, NORA V (MD, MS)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:V
Last Name:ESTEBAN-CRUCIANI
Suffix:
Gender:F
Credentials:MD, MS
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5501 OLD YORK RD
Mailing Address - Street 2:PALEY 1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3018
Mailing Address - Country:US
Mailing Address - Phone:215-456-7170
Mailing Address - Fax:215-456-3436
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:PALEY 1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-7170
Practice Address - Fax:215-456-3436
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY193867208000000X
PAMD459470208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics