Healthcare Provider Details

I. General information

NPI: 1356278378
Provider Name (Legal Business Name): MRS. SRIDEVI CHINTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE,
BOSTON MA
02215
US

IV. Provider business mailing address

3RD FLOOR, HEALTH4U MULTISPECIALTY CLINIC THOMAS COLONY, JUNGLIGHAT
SRIVIJAYAPURAM ANDAMAN AND NICOBAR ISLANDS
744101
IN

V. Phone/Fax

Practice location:
  • Phone: 617-667-3524
  • Fax: 617-667-3513
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number3021503
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: