Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | NJ34605 | NJ |
NPI | 1417916701 |
---|---|
Provider Name | Dr. Sasha Prakash |
First Address | Bayonne, NJ 07002-3915 |
Second Address | Bayonne, NJ 07002-3915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E01287 | (02) | NJ |