Provider Demographics
NPI:1790748374
Name:GOVIND, PRASHIL (MD)
Entity Type:Individual
Prefix:
First Name:PRASHIL
Middle Name:
Last Name:GOVIND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:80 MARCUS DR
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4230
Mailing Address - Country:US
Mailing Address - Phone:631-391-7889
Mailing Address - Fax:631-454-4161
Practice Address - Street 1:14601 45TH AVE
Practice Address - Street 2:ROOM 407
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2200
Practice Address - Country:US
Practice Address - Phone:718-670-5213
Practice Address - Fax:718-321-6004
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2013-01-17
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Provider Licenses
StateLicense IDTaxonomies
NY225790208000000X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02370212Medicaid
NYG400056785Medicare PIN
NY02370212Medicaid