Provider Demographics
NPI:1790733491
Name:DOSHI, PRAKASH J (MD)
Entity Type:Individual
Prefix:
First Name:PRAKASH
Middle Name:J
Last Name:DOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:206 BERGEN AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3324
Practice Address - Country:US
Practice Address - Phone:201-998-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA53168207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE22078Medicare UPIN
NJ034311Medicare ID - Type Unspecified