Provider Demographics
NPI:1265699912
Name:PRAJAPAT, LAXMAN (MD)
Entity type:Individual
Prefix:DR
First Name:LAXMAN
Middle Name:
Last Name:PRAJAPAT
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 1:149 SENECA PL
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-4003
Mailing Address - Country:US
Mailing Address - Phone:724-421-7881
Mailing Address - Fax:
Practice Address - Street 1:1249 PARK AVE
Practice Address - Street 2:17B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7219
Practice Address - Country:US
Practice Address - Phone:508-410-6803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435107207R00000X, 207RC0000X, 207RI0011X
MA239918207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease