MEDICARE: NALINI PRASAD MD PC

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	2084N0400X	Neurology Physician	25MA05653400	NJ

General Provider Information

NPI Number	:	1326383795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NALINI PRASAD MD PC

Provider Business Mailing Address
First Line	:	8103 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5048
Country	:	US
Telephone Number	:	201-758-0660
Fax Number	:	201-758-0635

Provider Business Practice Location Address
First Line	:	8103 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5048
Country	:	US
Telephone Number	:	201-758-0660
Fax Number	:	201-758-0635

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NALINI PRASAD
Credential	:	M.D.
Telephone Number	:	201-758-0660

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	03/13/2013

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