Provider Demographics
NPI:1629341771
Name:CEREJO, SUSHRUTA DUARA (MD)
Entity Type:Individual
Prefix:
First Name:SUSHRUTA
Middle Name:DUARA
Last Name:CEREJO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSHRUTA
Other - Middle Name:LAKHIRAJ
Other - Last Name:DUARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:490 E NORTH AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4740
Mailing Address - Country:US
Mailing Address - Phone:412-442-2522
Mailing Address - Fax:412-442-2524
Practice Address - Street 1:490 E NORTH AVE STE 309
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4740
Practice Address - Country:US
Practice Address - Phone:412-442-2522
Practice Address - Fax:412-442-2524
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD462469207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine