Organization
DEVINENI R PRASAD MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVINENI PRASAD M.D. (PEDIATRIC PHYSICIAN/OWNER)
(609) 567-0608
Entity
Organization
Contact information
Practice address
777 S WHITE HORSE PIKE, SUITE E1, HAMMONTON, NJ 08037-2029
(609) 567-0608
(609) 567-1295
Mailing address
777 S WHITE HORSE PIKE, SUITE E, HAMMONTON, NJ 08037-2029
(609) 567-0608
(609) 567-1295
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA03254600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1047520
HORIZON NJ HORIZON
NJ
05
—
2929201
—
NJ
Enumeration date
07/15/2008
Last updated
10/05/2012
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