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General NPI Number Information
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NPI Number | 1417916701
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Entity Type | Individual
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Provider Name | SASHA PRAKASH M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 534 AVENUE E SUITE 1-A
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City | BAYONNE
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State | NJ
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Zip | 07002-3915
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Country | US
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Telephone | 201-858-8444
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Fax | 201-858-4260
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Provider Business Mailing Address
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Address Line | 534 AVENUE E SUITE 1-A
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City | BAYONNE
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State | NJ
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Zip | 07002-3915
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Country | US
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Telephone | 201-858-8444
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Fax | 201-858-4260
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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 | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | NJ34605
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License Number State | NJ
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