Provider Demographics
NPI:1922101732
Name:PASUPULETI, SASI (MD)
Entity Type:Individual
Prefix:DR
First Name:SASI
Middle Name:
Last Name:PASUPULETI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SASI
Other - Middle Name:
Other - Last Name:PASUPULETI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:22 BENEDEK RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2228
Mailing Address - Country:US
Mailing Address - Phone:609-633-7054
Mailing Address - Fax:
Practice Address - Street 1:1620 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-3212
Practice Address - Country:US
Practice Address - Phone:609-633-7054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0464472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry