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Individual

BHAVANI PRAKASH RAO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1819 OAK TREE RD, EDISON, NJ 08820-2740
(908) 757-6655
(908) 757-6653
Mailing address
1819 OAKTREE ROAD, EDISON, NJ 08820
(908) 757-6655
(908) 322-5509

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA06751900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8159301
NJ
Enumeration date
09/01/2006
Last updated
10/18/2012
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