Deconda, Deepthi
Deconda, Deepthi is an sole proprietor health care provider with primary practice located at 1030 President Ave Suite 110, Fall River MA 02720-5923. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Deconda, Deepthi can be contacted via phone (508) 235-6349.Contact Information
Primary practice address
1030 President Ave Suite 110
Fall River MA 02720-5923
Phone: (508) 235-6349
Fax: (508) 973-1715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | MD14439 | Rhode Island |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 254999 | Massachusetts |
Profile Details
| NPI number | 1477727451 |
|---|---|
| LBN Legal business name | Deconda, Deepthi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 21st, 2008 |
| Last updated | Apr 21st, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477727451 | NPPES |
| Massachusetts | MEDICAID | 110096466A | |
| Massachusetts | MEDICAID | DD93883 |
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