Healthcare Provider Details

I. General information

NPI: 1205905379
Provider Name (Legal Business Name): SANDIP M PRASAD MD, MPHIL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 JAMES ST STE 2G
MORRISTOWN NJ
07960-6348
US

IV. Provider business mailing address

629 CRANBURY RD FL 2
EAST BRUNSWICK NJ
08816-4096
US

V. Phone/Fax

Practice location:
  • Phone: 973-539-0333
  • Fax:
Mailing address:
  • Phone: 732-390-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number25MA10061200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number225283
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: