# MR. SIDDHARTHA PRASAD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1295803633
- **Gender:** Man
- **Credential:** APN.C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM0705X | Medical-Surgical Registered Nurse | 26N011085000 | NJ | — |
| 363L00000X | Nurse Practitioner | RN603487 | PA | — |
| 363LA2200X | Adult Health Nurse Practitioner | 26NJ00120700 | NJ | — |
| 363LA2200X | Adult Health Nurse Practitioner | R221879 | MD | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | SP010259 | PA | — |

## Other

- **Enumeration date:** 12/02/2006
- **Last updated:** 07/05/2023