Organization
PRUSTY ENDOCRINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPANWITA PRUSTY M.D. (OWNER)
(617) 335-9363
Entity
Organization
Contact information
Practice address
571 MAIN ST, SECOND FLOOR, SOUTH WEYMOUTH, MA 02190-1843
(617) 335-9363
Mailing address
571 MAIN ST, SECOND FLOOR, SOUTH WEYMOUTH, MA 02190-1843
(617) 335-9363
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
228973
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11078614A
—
MA
Enumeration date
10/22/2015
Last updated
10/22/2015
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