Provider Demographics
NPI:1265268189
Name:THANKI, RIYA SHAILESH
Entity type:Individual
Prefix:
First Name:RIYA SHAILESH
Middle Name:
Last Name:THANKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 ELDREDGE ST # 2458
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2017
Mailing Address - Country:US
Mailing Address - Phone:617-969-4925
Mailing Address - Fax:781-769-6717
Practice Address - Street 1:64 ELDREDGE ST # 2458
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2017
Practice Address - Country:US
Practice Address - Phone:781-769-4143
Practice Address - Fax:781-769-6717
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical