Provider Demographics
NPI:1447747910
Name:PRASAD-PHILIP, MIRIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MIRIA
Middle Name:
Last Name:PRASAD-PHILIP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-1847
Mailing Address - Country:US
Mailing Address - Phone:845-826-1565
Mailing Address - Fax:
Practice Address - Street 1:HELEN HAYES HOSPITAL
Practice Address - Street 2:51-55 US-W
Practice Address - City:WEST HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10993
Practice Address - Country:US
Practice Address - Phone:845-786-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308443363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health