Provider Demographics
NPI:1760599138
Name:THOMAS, PRAKASH K (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAKASH
Middle Name:K
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:303 WHITNEY AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-7206
Mailing Address - Country:US
Mailing Address - Phone:203-500-5499
Mailing Address - Fax:203-453-2704
Practice Address - Street 1:303 WHITNEY AVE STE 8
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-7206
Practice Address - Country:US
Practice Address - Phone:203-500-5499
Practice Address - Fax:203-453-2704
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0425892084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry