Individual
PADMAJA PARAYATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 LIBERTY ST, BROCKTON, MA 02301-5674
(508) 565-0025
(508) 894-0412
Mailing address
110 LIBERTY ST, BROCKTON, MA 02301-5674
(508) 565-0025
(508) 894-0412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
51539
MA
207R00000X
Internal Medicine Physician
51539
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3134148
—
MA
Enumeration date
08/16/2005
Last updated
01/12/2024
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