Individual
DR. DEEPTHI GANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
795 CHESTNUT STREET, SPRINGFIELD, MA 01199-3134
(413) 794-0000
Mailing address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-0001
(413) 794-0000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD.46750
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G04801590051861
DRIVER LICENSE
NJ
Enumeration date
03/26/2019
Last updated
08/05/2025
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