Individual
PRASHANT JACOB THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 BERGEN ST, UNIVERSITY HOSPITAL, SUITE C-318, NEWARK, NJ 07103-2496
(313) 575-3961
Mailing address
150 BERGEN ST, UNIVERSITY HOSPITAL, SUITE C-318, NEWARK, NJ 07103-2496
(313) 575-3961
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301101286
MI
Other
Enumeration date
07/08/2012
Last updated
06/24/2013
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