Maria Estela O Prudencio, MD

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

MD035793E Issued in PA

Practice address

503 N 21St St
Camp Hill, PA 17011-2204

Phone

(717) 763-2205

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245457654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 HALYARD WAY",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251327",
            "telephone_number": "717-763-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112204",
            "telephone_number": "717-763-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDENCIO",
        "first_name": "MARIA ESTELA",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "PA",
            "license": "MD035793E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1682792",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Steven Allen Prophet, MD
• Kateryna Prosvirnina
• Christina Prudencio, CRNP
• Autumn Puchalsky
• Coreen A Puetz
• Erin Purcell, RN
• Leah Purdue
• William Purje, DC

• General Acute Care Hospital in Camp Hill, PA
• Providers in Camp Hill, PA by specialty
• General Acute Care Hospital in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.