Provider Demographics
NPI:1811506546
Name:YARRAMSETTY, DEEPTHI (MD)
Entity type:Individual
Prefix:
First Name:DEEPTHI
Middle Name:
Last Name:YARRAMSETTY
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 1:101 BURK AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3003
Mailing Address - Country:US
Mailing Address - Phone:484-714-8444
Mailing Address - Fax:
Practice Address - Street 1:1450 SCALP AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3339
Practice Address - Country:US
Practice Address - Phone:814-269-9551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD482015207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine