Provider Demographics
NPI:1568783314
Name:PUSATERI, TRITIA MARIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:TRITIA
Middle Name:MARIA
Last Name:PUSATERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:TRITIA
Other - Middle Name:MARIA
Other - Last Name:DESA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2702 N. 3RD STREET
Mailing Address - Street 2:SUITE 4020
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-4608
Mailing Address - Country:US
Mailing Address - Phone:602-243-7277
Mailing Address - Fax:602-323-3399
Practice Address - Street 1:6601 WEST THOMAS ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-5700
Practice Address - Country:US
Practice Address - Phone:602-243-7277
Practice Address - Fax:602-247-9742
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49269208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics