MEDICARE: DR. NALINI PRASAD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MA056534	NJ

General Provider Information

NPI Number	:	1881787679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NALINI PRASAD

Provider Business Mailing Address
First Line	:	8103 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8103 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5048
Country	:	US
Telephone Number	:	201-758-0660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	10/17/2017

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