Basic Information
| Provider Information | |||||||||
| NPI: | 1659770519 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALOMINO | ||||||||
| FirstName: | CRISTOPHER | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3550 TERRACE ST | ||||||||
| Address2: | CRITICAL CARE MEDICINE | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132500 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3550 TERRACE ST | ||||||||
| Address2: | CRITICAL CARE MEDICINE | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126473136 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2014 | ||||||||
| LastUpdateDate: | 04/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | SP014107 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 103019009 | 05 | PA | MEDICAID |