Individual
PRADEEP PRASAD DHITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 FRANKLIN AVENUE, VALLEY STREAM, NY 11580-4164
(516) 256-6164
Mailing address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6164
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
4301046537
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4586833
—
MI
Enumeration date
06/06/2006
Last updated
01/26/2012
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