Individual
LAXMINARAYAN PRABHAKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5000
Mailing address
123 HIGHLAND AVE STE 101, GLEN RIDGE, NJ 07028-1522
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA11677400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/26/2019
Last updated
03/11/2026
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