Basic Information
| Provider Information | |||||||||
| NPI: | 1912162835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANDRAREDDY | ||||||||
| FirstName: | ASHADEEP | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 WASHINGTON ST # 340 | ||||||||
| Address2: | DIVISION OF CLINICAL GENETICS, TUFTS NEMC | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176366098 | ||||||||
| FaxNumber: | 6176360745 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 WASHINGTON ST # 340 | ||||||||
| Address2: | DIVISION OF CLINICAL GENETICS, TUFTS NEMC | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176366098 | ||||||||
| FaxNumber: | 6176360745 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2008 | ||||||||
| LastUpdateDate: | 07/21/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207SG0201X | 237825 | MA | Y | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) |
No ID Information.