Healthcare Provider Details

I. General information

NPI: 1275277741
Provider Name (Legal Business Name): SARAH PUCKETT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BUFFALO RD
ERIE PA
16510-2304
US

IV. Provider business mailing address

4 ALLEGHENY CTR FL 7
PITTSBURGH PA
15212-5227
US

V. Phone/Fax

Practice location:
  • Phone: 814-897-2597
  • Fax:
Mailing address:
  • Phone: 412-330-5851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOT021430
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: