Healthcare Provider Details

I. General information

NPI: 1508995044
Provider Name (Legal Business Name): PRIYA SHALINI PRASHAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 1400
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

19 BRADHURST AVE SUITE 1400
HAWTHORNE NY
10532-2140
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7585
  • Fax: 914-594-4336
Mailing address:
  • Phone: 914-493-7585
  • Fax: 914-594-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD437097
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number267010
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number267010
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: