Individual
KANNEGANTI DIVYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-3992
(617) 573-3559
Mailing address
276 1ST ST APT 1J, MINEOLA, NY 11501-2366
(781) 606-1710
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
285729
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2017
Last updated
05/14/2026
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