Provider Demographics
NPI:1093926818
Name:KOTA, PRIYAMVADA (MD)
Entity Type:Individual
Prefix:
First Name:PRIYAMVADA
Middle Name:
Last Name:KOTA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:HARVARD VANGUARD MEDICAL ASSOCIATES/ATRIUS HEALTH
Mailing Address - Street 2:230 WORCESTER STREET
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:781-431-5270
Mailing Address - Fax:781-431-5535
Practice Address - Street 1:HARVARD VANGUARD MEDICAL ASSOCIATES
Practice Address - Street 2:230 WORCESTER STREET
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481
Practice Address - Country:US
Practice Address - Phone:781-431-5270
Practice Address - Fax:781-431-5535
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-01-06
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2311432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry