Provider Demographics
NPI:1376634550
Name:PRABHU, ASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHA
Middle Name:
Last Name:PRABHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 RAWLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243
Mailing Address - Country:US
Mailing Address - Phone:412-276-6068
Mailing Address - Fax:814-726-4447
Practice Address - Street 1:33 MAIN DR
Practice Address - Street 2:
Practice Address - City:NORTH WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-5001
Practice Address - Country:US
Practice Address - Phone:814-726-4317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060113L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA159751OtherMEDICARE ID-TYPE SPECIFIED
PA159751OtherMEDICARE ID-TYPE SPECIFIED
PA260031773Medicare PIN