Provider Demographics
NPI:1154564227
Name:REDDY, PRANITHA (MD)
Entity type:Individual
Prefix:
First Name:PRANITHA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PLEASANT ST
Mailing Address - Street 2:BOX 315
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2427
Mailing Address - Country:US
Mailing Address - Phone:781-331-2000
Mailing Address - Fax:781-337-6104
Practice Address - Street 1:70 PLEASANT ST
Practice Address - Street 2:BOX 315
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2427
Practice Address - Country:US
Practice Address - Phone:781-331-2000
Practice Address - Fax:781-337-6104
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT050658207R00000X
MA255170207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine