Individual
PRAKASH N NAYAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 JACKSON ST, POTTSVILLE, PA 17901
(570) 346-7797
(570) 342-9802
Mailing address
PO BOX 390, SCRANTON, PA 18501
(570) 346-7797
(570) 342-9802
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD417844
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01907963
—
PA
01
—
050088257
RR MEDICARE
PA
01
—
P00134546
RR MEDICARE
PA
Enumeration date
11/15/2005
Last updated
05/06/2009
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