Individual
PETER PUTHENVEETIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 LANGHORNE NEWTOWN RD, LANGHORNE, PA 19047-1201
(215) 701-2100
Mailing address
1027 ARCH ST APT 709, PHILADELPHIA, PA 19107-2328
(219) 776-9035
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD460622
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/03/2014
Last updated
01/31/2018
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