Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD461063 | PA |
NPI | 1225457641 |
---|---|
Provider Name | Sahithi Gosala |
First Address | Reading, PA 19612-3579 |
Second Address | West Reading, PA 19611-2143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 23/01/2019 |