Provider Demographics
NPI:1588814446
Name:PINGILI, SARITHA (MD)
Entity Type:Individual
Prefix:
First Name:SARITHA
Middle Name:
Last Name:PINGILI
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 1:103 BARKLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2256
Mailing Address - Country:US
Mailing Address - Phone:516-233-0148
Mailing Address - Fax:
Practice Address - Street 1:103 BARKLEDGE DR
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2256
Practice Address - Country:US
Practice Address - Phone:516-233-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046729174400000X
CT467292080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT46729OtherCT LICENSE