Basic Information
| Provider Information | |||||||||
| NPI: | 1154977841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAVA SUAREZ | ||||||||
| FirstName: | CORINA | ||||||||
| MiddleName: | CRISTINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5501 OLD YORK RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191413098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1545670202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5501 OLD YORK RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191413098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1545670202 | ||||||||
| FaxNumber: | 2155726456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2019 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RE0101X | MT224811 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.