Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 15044 | NH |
NPI | 1063603967 |
---|---|
Provider Name | Deeptha N. Sastry |
First Address | Portsmouth, NH 03801-4125 |
Second Address | Portsmouth, NH 03801-4125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 18/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32000024 | (05) | NH |