Provider Demographics
NPI:1477110203
Name:SANATA, KELSEY ANN (OD, MS)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ANN
Last Name:SANATA
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:ANN
Other - Last Name:FERLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 STONERIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-7924
Mailing Address - Country:US
Mailing Address - Phone:724-301-3377
Mailing Address - Fax:
Practice Address - Street 1:105 BRANDT DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6437
Practice Address - Country:US
Practice Address - Phone:724-772-5420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003654152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist