Provider Demographics
NPI:1215719877
Name:LAD, PRANAV V (ND)
Entity type:Individual
Prefix:DR
First Name:PRANAV
Middle Name:V
Last Name:LAD
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 SETTER DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-6609
Mailing Address - Country:US
Mailing Address - Phone:847-525-6287
Mailing Address - Fax:
Practice Address - Street 1:10409 MONTGOMERY PKWY NE STE 203B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3852
Practice Address - Country:US
Practice Address - Phone:505-359-3578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMND-0025175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath