Individual
MR. SIDDHARTHA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN.C
Contact information
Practice address
1 ROBERT WOOD JOHNSON PL, SPECIAL PROCEDURES, NEW BRUNSWICK, NJ 08901-1928
(732) 828-3000
Mailing address
4560 SHADOWSTONE DR, FORKS TOWNSHIP, PA 18040-6694
(732) 801-8326
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
26N011085000
NJ
363L00000X
Nurse Practitioner
RN603487
PA
363LA2200X
Adult Health Nurse Practitioner
26NJ00120700
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
R221879
MD
363LA2200X
Adult Health Nurse Practitioner
SP010259
PA
Other
Enumeration date
12/02/2006
Last updated
07/05/2023
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