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General NPI Number Information
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NPI Number | 1346621414
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Entity Type | Individual
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Provider Name | SARAH DIVITTORIO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1501 N CAMPBELL AVE FL 8 DEPT OF OB/GYN
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City | TUCSON
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State | AZ
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Zip | 85724-0001
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Country | US
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Telephone | 520-694-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 3850 E HAMPTON ST
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City | TUCSON
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State | AZ
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Zip | 85716-2946
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Country | US
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Telephone | 858-405-0703
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R74983
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License Number State | AZ
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