Provider Demographics
NPI:1124753835
Name:PRASAD, BIANCA
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:PRASAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13534 129TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3710
Mailing Address - Country:US
Mailing Address - Phone:516-824-4219
Mailing Address - Fax:
Practice Address - Street 1:13534 129TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-3710
Practice Address - Country:US
Practice Address - Phone:516-824-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker