Prasanna Vasudevan, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

269778 Issued in OK

Practice address

990 Stewart Ave
Suite 400
Garden City, NY 11530-4822

Phone

(516) 222-2022

Fax

(516) 222-8475

NPI assigned

Jun 10, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1043470552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 STEWART AVE",
            "address_2": "SUITE 400",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304822",
            "telephone_number": "516-222-2022",
            "fax_number": "516-222-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 STEWART AVE",
            "address_2": "SUITE 400",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304822",
            "telephone_number": "516-222-2022",
            "fax_number": "516-222-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASUDEVAN",
        "first_name": "PRASANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "25945255",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "269778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tressa Varghese, OD
• P Leo Varriale, MD
• Nikolaos Vartholomeos, PT
• Ho Yin Vasquez, LCSW
• Peter D. Vastardis, D.M.D.
• Erica Lizbeth Vazquez
• Katlyn Marie Vecchio, LMSW
• Haritha Bodduluri Veeramachaneni, MD
• Danielle Velazquez, LCAT
• Jason Mitchell Velez

• Diagnostic Radiology Physician in Garden City, NY
• Providers in Garden City, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.