Organization
PUNAM PRABHAKAR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PUNAM PRABHAKAR MD (OWNER/AUTHORIZED OFFICIAL)
(917) 224-4496
Entity
Organization
Contact information
Practice address
2200 NORTHERN BLVD STE 128, GREENVALE, NY 11548-1221
(917) 224-4496
Mailing address
2200 NORTHERN BLVD STE 128, GREENVALE, NY 11548-1221
(516) 415-0514
(516) 277-2277
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
12/12/2017
Last updated
04/03/2018
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