Provider Demographics
NPI:1922368125
Name:THANAWALA, PRACHI U (MD)
Entity type:Individual
Prefix:DR
First Name:PRACHI
Middle Name:U
Last Name:THANAWALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 CAPITAL WAY
Mailing Address - Street 2:STE 385
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-303-4838
Mailing Address - Fax:609-303-4835
Practice Address - Street 1:2 CAPITAL WAY STE 385
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-303-4838
Practice Address - Fax:609-303-4835
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY294406207RC0000X
NJ25MA10066400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease