Provider Demographics
NPI:1912162835
Name:CHANDRAREDDY, ASHADEEP (MD)
Entity type:Individual
Prefix:DR
First Name:ASHADEEP
Middle Name:
Last Name:CHANDRAREDDY
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 1:800 WASHINGTON ST # 340
Mailing Address - Street 2:DIVISION OF CLINICAL GENETICS, TUFTS NEMC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-6098
Mailing Address - Fax:617-636-0745
Practice Address - Street 1:800 WASHINGTON ST # 340
Practice Address - Street 2:DIVISION OF CLINICAL GENETICS, TUFTS NEMC
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-6098
Practice Address - Fax:617-636-0745
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237825207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)