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Individual

PRIYANKA PRAKASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3850
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
266242
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1073824041
FALLON COMMUNITY HEALTH PLAN
MA
05
110113586A
MA
01
AA502387
HARVARD PILGRIM HEALTH CARE
MA
Enumeration date
06/24/2010
Last updated
12/01/2022
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