MEDICARE: ROMITA PRASAD DPT

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	2251C2600X	Cardiopulmonary Physical Therapist	40589	CA
2	2251E1200X	Ergonomics Physical Therapist	40589	CA
3	2251G0304X	Geriatric Physical Therapist	40589	CA
4	2251N0400X	Neurology Physical Therapist	40589	CA
5	2251X0800X	Orthopedic Physical Therapist	40589	CA
6	225100000X	Physical Therapist	40589	CA

General Provider Information

NPI Number	:	1629406335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMITA PRASAD DPT

Provider Business Mailing Address
First Line	:	660 RATTAN CT
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-7728
Country	:	US
Telephone Number	:	510-825-5930
Fax Number	:

Provider Business Practice Location Address
First Line	:	660 RATTAN CT
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-7728
Country	:	US
Telephone Number	:	510-825-5930
Fax Number	:

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

Provider Enumeration Date	:	10/16/2013
Last Update Date	:	10/15/2020

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Directions to “ ROMITA PRASAD DPT” Practice Location

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