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General NPI Number Information
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NPI Number | 1871682260
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Entity Type | Individual
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Provider Name | PRABHAKARA SOMAYAJI MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 549 4TH ST STE 1
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1530
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Country | US
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Telephone | 716-285-0853
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Fax | 716-284-2034
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Provider Business Mailing Address
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Address Line | 549 4TH ST STE 1
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1530
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Country | US
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Telephone | 716-285-0853
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Fax | 716-284-2034
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 142353-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 142353
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License Number State | NY
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