Individual
SAJA C PUTHIYOTTIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1969 W HART RD, ATTN: ANESTHESIA DEPT, BELOIT, WI 53511-2230
(608) 364-5355
(608) 362-0417
Mailing address
3005 RIVERSIDE, SUITE 206, BELOIT, WI 53511-1500
(608) 362-7444
(608) 362-0417
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F0216734
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
6833-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285093351
—
WI
Enumeration date
02/18/2016
Last updated
10/16/2019
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