Healthcare Provider Details

I. General information

NPI: 1457585077
Provider Name (Legal Business Name): APARNA PRASAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE DEPT OF PEDIATRIC CARDIOLOGY, 2ND FLOOR
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

100 MADISON AVENUE GORYEB CHILDREN'S HOSPITAL
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number25MA09123400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: