Provider Demographics
NPI:1699534552
Name:GUDAPAKKAM, SMITHA
Entity type:Individual
Prefix:
First Name:SMITHA
Middle Name:
Last Name:GUDAPAKKAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5032
Mailing Address - Country:US
Mailing Address - Phone:315-395-3628
Mailing Address - Fax:
Practice Address - Street 1:288 SPRING ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-5032
Practice Address - Country:US
Practice Address - Phone:315-395-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty