Healthcare Provider Details

I. General information

NPI: 1063114114
Provider Name (Legal Business Name): SUSANNAH PITT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 MILES RD STE 1
WEST CHESTER PA
19380-1950
US

IV. Provider business mailing address

770 MILES RD STE 1
WEST CHESTER PA
19380-1950
US

V. Phone/Fax

Practice location:
  • Phone: 610-436-8611
  • Fax:
Mailing address:
  • Phone: 610-436-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD49518
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: