Provider Demographics
NPI:1457568354
Name:BERTUCCI, MARIA J (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:BERTUCCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8765 STENTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8317
Mailing Address - Country:US
Mailing Address - Phone:215-836-2440
Mailing Address - Fax:215-836-2448
Practice Address - Street 1:8765 STENTON AVENUE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-8317
Practice Address - Country:US
Practice Address - Phone:215-836-2440
Practice Address - Fax:215-836-2448
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430331207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019786540001Medicaid
PA1019786540001Medicaid
PA111013Medicare PIN