Prakash, Renu B
Prakash, Renu B is an individual health care provider with primary practice located at 60 Grand St , Canton MA 02021-1836. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Prakash, Renu B can be contacted via phone (781) 821-0194.Contact Information
Primary practice address
60 Grand St
Canton MA 02021-1836
Phone: (781) 821-0194
Fax: (781) 821-0194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 159456 | Massachusetts |
Profile Details
| NPI number | 1033104674 |
|---|---|
| LBN Legal business name | Prakash, Renu B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Apr 28th, 2014 - about 11 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 | 1033104674 | NPPES |
| Massachusetts | Other | S400105529 | MEDICARE - GROUP #003473101 |
| Massachusetts | Other | S400105532 | MEDICARE - GROUP #003473101 |
| Massachusetts | MEDICAID | 3190935 | MEDICARE - GROUP #003473101 |
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