Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00292900 | NJ |
NPI | 1013107184 |
---|---|
Provider Name | Dr. Manooj Prasad |
First Address | Lakewood, NJ 08701-5227 |
Second Address | Lakewood, NJ 08701-5227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 25/07/2007 |