Provider Demographics
NPI:1407862519
Name:PRASAD, NILOO (MD)
Entity Type:Individual
Prefix:MRS
First Name:NILOO
Middle Name:
Last Name:PRASAD
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 1:2177 OAK TREE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:908-755-1165
Mailing Address - Fax:908-755-2093
Practice Address - Street 1:2177 OAK TREE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:908-755-1165
Practice Address - Fax:908-755-2093
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59131207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5473306Medicaid
NJ5473306Medicaid
NJ884153Medicare ID - Type Unspecified