Provider Demographics
NPI:1962607952
Name:PRASAD, DEEPALI (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPALI
Middle Name:
Last Name:PRASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 SPOTWOOD ENGLISHTOWN RD SUIT B
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-8589
Mailing Address - Country:US
Mailing Address - Phone:732-388-7999
Mailing Address - Fax:732-416-0470
Practice Address - Street 1:323 SPOTWOOD ENGLISHTOWN RD SUIT B
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-8589
Practice Address - Country:US
Practice Address - Phone:732-388-7999
Practice Address - Fax:732-416-0470
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08665400207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty