Provider Demographics
NPI:1831120674
Name:SAIRITUPA, ZAHIDA (APRN-BC)
Entity Type:Individual
Prefix:
First Name:ZAHIDA
Middle Name:
Last Name:SAIRITUPA
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 NORTH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5653
Mailing Address - Country:US
Mailing Address - Phone:203-748-1200
Mailing Address - Fax:203-790-0010
Practice Address - Street 1:72 NORTH ST STE 103
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5653
Practice Address - Country:US
Practice Address - Phone:203-748-1200
Practice Address - Fax:203-790-0010
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003119363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health