Provider Demographics
NPI:1851495071
Name:ASWATHAPPA, SATHYA N (MD)
Entity Type:Individual
Prefix:DR
First Name:SATHYA
Middle Name:N
Last Name:ASWATHAPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 6TH AVENUE
Mailing Address - Street 2:PEDIATRIC HEALTHCARE ASSOCIATES
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602
Mailing Address - Country:US
Mailing Address - Phone:814-944-7383
Mailing Address - Fax:814-944-7608
Practice Address - Street 1:615 6TH AVENUE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-944-7383
Practice Address - Fax:814-944-7608
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059445L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015890180001Medicaid
PA075601OtherMED
PA21262OtherGEISINGER
PA868025OtherBS
PA203245OtherUPMC BEST
PAP0000894OtherGATEWAY
34161OtherHEALTH ASSUR
34161OtherHEALTH ASSUR