MEDICARE: LAKSHMI PRASAD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA06947500	NJ

General Provider Information

NPI Number	:	1033165295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKSHMI PRASAD M.D.

Provider Business Mailing Address
First Line	:	36 HANSOM RD
Second Line	:
City	:	BASKING RIDGE
State	:	NJ
Zip	:	07920-2973
Country	:	US
Telephone Number	:	908-470-0003
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 MOUNTAIN BLVD
Second Line	:	SUITE 9
City	:	WARREN
State	:	NJ
Zip	:	07059-5605
Country	:	US
Telephone Number	:	908-769-9600
Fax Number	:	908-769-9610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	11/30/2007

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