Individual
PRASANNA VASUDEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
990 STEWART AVE, SUITE 400, GARDEN CITY, NY 11530-4822
(516) 222-2022
(516) 222-8475
Mailing address
990 STEWART AVE, SUITE 400, GARDEN CITY, NY 11530-4822
(516) 222-2022
(516) 222-8475
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
269778
OK
390200000X
Student in an Organized Health Care Education/Training Program
25945255
PA
Other
Enumeration date
06/10/2008
Last updated
05/06/2014
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