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General NPI Number Information
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NPI Number | 1043321706
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Entity Type | Individual
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Provider Name | RANJOO K PRASAD OD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 3900 WOODLAND AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4551
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Country | US
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Telephone | 215-823-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 6232 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-2922
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Country | US
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Telephone | 215-222-7540
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OE008346T
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License Number State | PA
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