Ms. Sreesubha P Chittamooru, PHYSICIAN ASSISTANT
Physician Assistant in Worcester, Massachusetts
1639454960- Practice location
- 55 Lake Ave N, Worcester, MA 01655-0002
- Phone
- 508-334-0605
- Fax
- 508-856-5074
- Last updated
- November 6, 2024
Sreesubha P Chittamooru is a Physician Assistant based in Worcester, MA. Sreesubha P Chittamooru practices in Worcester, MA and has the professional credentials of PHYSICIAN ASSISTANT. The NPI Number for Sreesubha P Chittamooru is 1639454960 and holds a License No. PA4578 (MA). The current practice location address for Sreesubha P Chittamooru is 55 Lake Ave N, Worcester, MA 01655-0002 and can be reached out via phone at 508-334-0605 and via fax at 508-856-5074.
Provider Profile Details
- NPI Number
- 1639454960
- Provider Name
- Sreesubha P Chittamooru
- Credential
- PHYSICIAN ASSISTANT
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 55 Lake Ave N, Worcester, MA 01655-0002
- Phone Number
- 508-334-0605
- Fax Number
- 508-856-5074
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- October 18, 2011
- Last Update Date
- November 6, 2024
- Certification Date
- November 6, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 55 Lake Ave N
Worcester, MA 01655-0002 - City
- Worcester
- State
- Massachusetts
- Zip
- 01655-0002
- Phone Number
- 508-334-0605
- Fax Number
- 508-856-5074
Provider Business Mailing Address Details
- Address
- Po Box 415348
Boston, MA 02241-5348 - City
- Boston
- State
- MA
- Zip
- 02241-5348
- Phone Number
- 800-225-8885
- Fax Number
- 508-334-1977
License Information
- License Number (1)
- PA4578
- License State (1)
- MA
- Taxonomy (1)
- Physician Assistant · 363A00000X · Primary
- License Number (2)
- 2665
- License State (2)
- CT
- Taxonomy (2)
- Physician Assistant · 363A00000X
- License Number (3)
- 2665
- License State (3)
- CT
- Taxonomy (3)
- Physician Assistant, Surgical · 363AS0400X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ms. Sreesubha P Chittamooru, PHYSICIAN ASSISTANT?
The NPI number of Ms. Sreesubha P Chittamooru, PHYSICIAN ASSISTANT is 1639454960. It was assigned on October 18, 2011 and is currently active in the NPPES registry.
What is the specialty of Ms. Sreesubha P Chittamooru, PHYSICIAN ASSISTANT?
Ms. Sreesubha P Chittamooru, PHYSICIAN ASSISTANT is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in MA under license number PA4578.
Where does Ms. Sreesubha P Chittamooru, PHYSICIAN ASSISTANT practice?
The practice location is 55 Lake Ave N, Worcester, MA 01655-0002. The office can be reached at 508-334-0605 (phone) or 508-856-5074 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1639454960 directly on the NPPES registry website.