Individual
VIJAYA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M,.D.
Contact information
Practice address
703 MAIN ST, ST. JOSEPH'S REGIONAL MEDICAL CENTER, PATERSON, NJ 07503-2621
(973) 754-2541
Mailing address
703 MAIN ST, ST. JOSEPH'S REGIONAL MEDICAL CENTER, PATERSON, NJ 07503-2621
(973) 754-2052
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
25MA04750000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7875207
—
NJ
Enumeration date
06/28/2006
Last updated
07/08/2007
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