Dimitra Christoforatos

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP008184 Issued in PA

Practice address

2000 Sproul Road
Suite 206
Broomall, PA 19008

Phone

(610) 284-0200

Fax

(610) 353-7932

NPI assigned

May 14, 2007

Last updated

Nov 10, 2014By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Hospital of Philadelphia

  dba Care Network Flourtown

  • Pediatrics Physician
  • Erdenheim, PA
  • NPI 1831262732
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1740495506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 SPROUL ROAD",
            "address_2": "SUITE 206",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "19008",
            "telephone_number": "610-284-0200",
            "fax_number": "610-353-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SPROUL ROAD",
            "address_2": "SUITE 206",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "19008",
            "telephone_number": "610-284-0200",
            "fax_number": "610-353-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOFORATOS",
        "first_name": "DIMITRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP008184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN526518L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP LICENSE",
            "identifier": "SP008184",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTION AUTH",
            "identifier": "003706",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Child and Family Focus, Inc.
• Children's Hospital of Philadelphia
• Meya Lacha Childs, BEHAVIOR TECHNICIAN
• Nabila Chowdhury, M.D.
• Christiana Care Pennsylvania Inc (CCHS Specialty Services PA)
• Church Lane Senior Services, LLC (Brighten at Broomall)
• Roni Cibischino
• Elise Beth Ciner, O.D.
• Jessica Cirillo
• Jennifer L Claves, MD

• Pediatric Nurse Practitioner in Broomall, PA
• Providers in Broomall, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.