Individual
SANTWANA PRASAD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
300 STAFFORD ST, SUITE 212, SPRINGFIELD, MA 01104-3581
(413) 739-7367
Mailing address
300 STAFFORD ST, SUITE 212, SPRINGFIELD, MA 01104-3581
(413) 739-7367
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
4370
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0368977
CIGNA HEALTHCARE ID NO.
MA
01
—
043700
CONNECTICARE ID NO.
CT
01
—
33797
HEALTH NEW ENGLAND ID NO.
MA
01
—
3875267
AETNA/USHEALTHCARE
MA
01
—
467469
TUFTS ID NO.
MA
01
—
W16421
CT.BLUE SHIELD ID NO.
CT
01
—
W16421
BLUE SHIELD OF MASS ID NO
MA
Enumeration date
10/24/2005
Last updated
07/08/2007
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