Individual
SANTISREE TANIKELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4203 HOSPITAL RD., COAL TOWNSHIP, PA 17866-6041
(570) 648-4010
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD460347
PA
390200000X
Student in an Organized Health Care Education/Training Program
390200000X
—
Other
Enumeration date
07/29/2011
Last updated
08/30/2020
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