Provider Demographics
NPI:1881221133
Name:PRASHAD, NADANA (MS, CFY-SLP, TSSLD)
Entity Type:Individual
Prefix:
First Name:NADANA
Middle Name:
Last Name:PRASHAD
Suffix:
Gender:F
Credentials:MS, CFY-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10857 ROOSEVELT AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-5629
Mailing Address - Country:US
Mailing Address - Phone:516-582-6357
Mailing Address - Fax:
Practice Address - Street 1:77 N CENTRE AVE STE 215
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3923
Practice Address - Country:US
Practice Address - Phone:631-363-5794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2255A2300X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer