Individual
DEEPA PRAKASH ARYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 WALL ST, INTERNAL MEDICINE, BURLINGTON, MA 01803-4758
(781) 221-2600
(781) 221-8637
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
80360
MA
207QA0505X
Adult Medicine Physician
Primary
80360
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080360
TUFTS
MA
05
—
2027461
—
MA
01
—
AA2921
HARVARD PILGRIM
MA
01
—
J14943
BLUE CROSS
MA
Enumeration date
01/26/2006
Last updated
05/16/2011
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