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General NPI Number Information
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NPI Number | 1003853698
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Entity Type | Individual
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Provider Name | RAJEEV PRASAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 701 OSTRUM ST STE 102
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1152
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Country | US
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Telephone | 484-658-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 701 OSTRUM ST STE 102
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1152
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Country | US
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Telephone | 484-658-5437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | MD064459L
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License Number State | PA
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