Provider Demographics
NPI:1740740513
Name:PRASHAD, TREVOR TOMESH (DO)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:TOMESH
Last Name:PRASHAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7818
Mailing Address - Country:US
Mailing Address - Phone:516-343-0316
Mailing Address - Fax:
Practice Address - Street 1:2053 BELLMORE AVE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5603
Practice Address - Country:US
Practice Address - Phone:516-679-3627
Practice Address - Fax:516-679-3631
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine