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General NPI Number Information
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NPI Number | 1306969282
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Entity Type | Individual
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Provider Name | SAILAJA PUTTAGUNTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 56 FRANKLIN ST
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City | WATERBURY
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State | CT
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Zip | 06706-1221
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Country | US
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Telephone | 203-709-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 39 BUELL HILL RD
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City | KILLINGWORTH
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State | CT
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Zip | 06419-1315
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Country | US
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Telephone | 860-661-0634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 036200
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License Number State | CT
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