Provider Demographics
NPI:1629396106
Name:PUTTA, SARITHA
Entity Type:Individual
Prefix:
First Name:SARITHA
Middle Name:
Last Name:PUTTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 SETTLERS DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8788
Mailing Address - Country:US
Mailing Address - Phone:412-635-0468
Mailing Address - Fax:
Practice Address - Street 1:201 DEVINE DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7650
Practice Address - Country:US
Practice Address - Phone:724-935-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-09
Last Update Date:2010-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist