Provider Demographics
NPI:1073708939
Name:CHENNAPATNA MANJUNATH, NAYANA DEEPTI (MD)
Entity type:Individual
Prefix:DR
First Name:NAYANA DEEPTI
Middle Name:
Last Name:CHENNAPATNA MANJUNATH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MESSENGER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2258
Mailing Address - Country:US
Mailing Address - Phone:508-809-6379
Mailing Address - Fax:508-342-1908
Practice Address - Street 1:60 MESSENGER ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2258
Practice Address - Country:US
Practice Address - Phone:508-809-6379
Practice Address - Fax:508-342-1908
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1021672207V00000X
RIMD13710207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology