Basic Information
| Provider Information | |||||||||
| NPI: | 1568810273 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KATTA | ||||||||
| FirstName: | SAI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 221 MADISON PL | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015454288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159083352 | ||||||||
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| Practice Location | |||||||||
| Address1: | 123 SUMMER STREET | ||||||||
| Address2: | SAINT VINCENT HOSPITAL | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083636208 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2016 | ||||||||
| LastUpdateDate: | 06/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 267778 | MA | N | Hospitals | General Acute Care Hospital | 207RE0101X | 289955 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.