Individual
SRAVANTHI VYSETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-4586
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 526-4586
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OT021577
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT021577
PA TRAINING LICENSE
PA
Enumeration date
06/06/2022
Last updated
06/06/2022
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