Individual
MS. DEEPANWITA PRUSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
544 MAIN ST LOWR LEVEL, SOUTH WEYMOUTH, MA 02190-1818
(339) 201-4053
(781) 871-3425
Mailing address
544 MAIN ST LOWR LEVEL, WEYMOUTH, MA 02190-1818
(392) 014-0533
(781) 871-3425
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
214928
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042297845
UNITED HEALTH CARE
—
05
—
11078614A
—
MA
01
—
1861473514
NEIGHBORHOOD HEALTH PLAN
MA
01
—
1861473514
NHP
—
01
—
459067
TUFTS AND TUFTS MEDICARE PREFERRED
—
01
—
7541384
CIGNA
—
01
—
9355125
AETNA
—
01
—
AA193220
HARVARD PILGRIM
—
01
—
SS0074
BCBSMA
MA
Enumeration date
11/09/2005
Last updated
10/23/2025
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