Mudigonda, Sanjay
Mudigonda, Sanjay is an individual health care provider with primary practice located at 2014 Washington Street , Newton MA 02462. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mudigonda, Sanjay can be contacted via phone (617) 243-6162.Contact Information
Primary practice address
2014 Washington Street
Newton MA 02462
Phone: (617) 243-6162
Fax: (207) 347-7401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 221962 | Massachusetts |
Profile Details
| NPI number | 1942277983 |
|---|---|
| LBN Legal business name | Mudigonda, Sanjay |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Sep 27th, 2011 - about 13 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 | 1942277983 | NPPES |
| Massachusetts | MEDICAID | 2066262 | |
| Massachusetts | Other | J28221 | |
| Massachusetts | Other | 467604 |
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