Provider Demographics
NPI:1417989419
Name:PUSTI, JANINE (MD)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:PUSTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 THIRWELL AVE
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-7738
Mailing Address - Country:US
Mailing Address - Phone:570-454-0309
Mailing Address - Fax:570-450-6330
Practice Address - Street 1:327 THIRWELL AVE
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-7738
Practice Address - Country:US
Practice Address - Phone:570-454-0309
Practice Address - Fax:570-450-6330
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059021L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA952789Q1CMedicare ID - Type Unspecified