Prusty, Deepanwita

Prusty, Deepanwita is an individual health care provider with primary practice located at 541 Main St 2Nd , South Weymouth MA 02190-1868. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Prusty, Deepanwita can be contacted via phone (781) 812-2880.

Contact Information

Primary practice address
541 Main St 2Nd South Weymouth MA 02190-1868
Phone: (781) 812-2880
Fax: (781) 803-6142
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 214928 Massachusetts

Profile Details

NPI number 1861473514
LBN Legal business name Prusty, Deepanwita
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Feb 16th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861473514 NPPES
Other 042297845 TRICARE
Other 1861473514 TRICARE
Other SS0074 TRICARE
Other 042297845 TRICARE
Other 042297845 TRICARE
Other 042297845 TRICARE
MEDICAID 11078614A TRICARE
Other 042297845 TRICARE
Other 1861473514 TRICARE
Other 9355125 TRICARE
Other 7541384 TRICARE
Other 042297845 TRICARE
Other 1861473514 TRICARE
Other 459067 TRICARE
Other AA193220 TRICARE

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