Provider Demographics
NPI:1679510838
Name:RAMENENI, ANURADHA (MD)
Entity Type:Individual
Prefix:
First Name:ANURADHA
Middle Name:
Last Name:RAMENENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-521-3210
Mailing Address - Fax:978-469-5663
Practice Address - Street 1:1 PARKWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-521-3210
Practice Address - Fax:978-469-5663
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207512207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2415434Medicaid
OHH29487Medicare UPIN
OH7315051Medicare PIN
OH2415434Medicaid