Healthcare Provider Details

I. General information

NPI: 1629396106
Provider Name (Legal Business Name): SARITHA PUTTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2010
Last Update Date: 05/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DEVINE DR
WEXFORD PA
15090-7650
US

IV. Provider business mailing address

1607 SETTLERS DR
SEWICKLEY PA
15143-8788
US

V. Phone/Fax

Practice location:
  • Phone: 724-935-1880
  • Fax:
Mailing address:
  • Phone: 412-635-0468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP442015
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: