Individual
MANJU L PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 YORK ST, EP#2-608B, NEW HAVEN, CT 06510-3220
(203) 737-4862
(203) 737-2922
Mailing address
20 YORK ST, EP#2-608B, NEW HAVEN, CT 06510-3220
(203) 737-4862
(203) 737-2922
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
043615
CT
207ZP0101X
Anatomic Pathology Physician
220310
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2067030
—
MA
Enumeration date
10/31/2005
Last updated
05/04/2009
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