Provider Demographics
NPI:1487632659
Name:TIRRITO, SALVATORE J (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:J
Last Name:TIRRITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 N CAMPBELL AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1563
Mailing Address - Country:US
Mailing Address - Phone:520-838-2138
Mailing Address - Fax:520-838-2260
Practice Address - Street 1:4729 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-321-4800
Practice Address - Fax:520-838-2400
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14487R207RC0000X
AZ33344207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ917487Medicaid
H76716Medicare UPIN
AZ917487Medicaid
AZZ101371Medicare PIN
AZZ116484Medicare PIN
AZZ105614Medicare PIN