Provider Demographics
NPI:1033579891
Name:KARUNANITHI, SANGEETHA PRIYA
Entity Type:Individual
Prefix:
First Name:SANGEETHA
Middle Name:PRIYA
Last Name:KARUNANITHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0001
Mailing Address - Country:US
Mailing Address - Phone:267-370-5295
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:2100 N LINE ST
Practice Address - Street 2:APT H203
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1043
Practice Address - Country:US
Practice Address - Phone:302-983-9549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily