Healthcare Provider Details

I. General information

NPI: 1356273197
Provider Name (Legal Business Name): SAI VENKATA SIDDHARTHA MASETTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORNERSTONE CARE 120 LOCUST AVENUE EXTENSION
MOUNT MORRIS PA
15349-1355
US

IV. Provider business mailing address

CORNERSTONE CARE 120 LOCUST AVENUE EXTENSION
MOUNT MORRIS PA
15349-1355
US

V. Phone/Fax

Practice location:
  • Phone: 724-324-9001
  • Fax: 724-324-9005
Mailing address:
  • Phone: 724-324-9001
  • Fax: 724-324-9005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: