Provider Demographics
NPI:1457659054
Name:BRAR, PRABHJOT KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:PRABHJOT
Middle Name:KAUR
Last Name:BRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:465 GYPSY LN
Mailing Address - Street 2:APT 308
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1361
Mailing Address - Country:US
Mailing Address - Phone:330-884-1000
Mailing Address - Fax:
Practice Address - Street 1:500 GYPSY LN
Practice Address - Street 2:REGIONAL REFERRAL CENTER, 2ND FLOOR
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1315
Practice Address - Country:US
Practice Address - Phone:330-884-4252
Practice Address - Fax:330-884-0656
Is Sole Proprietor?:No
Enumeration Date:2011-03-05
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098790208M00000X
OH57.015976207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine