Rangachar Keshava Prasad, M.D.
Individual provider Active NPI Adolescent Medicine (Internal Medicine) Physician · Jamesville, NY
NPI 1124276290 · NPPES record last updated Mar 16, 2011
Key facts
- NPI
- 1124276290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adolescent Medicine (Internal Medicine) Physician 207RA0000X
- License
- A35978 (CA)
- Practice address
- 4578 Reliant Rd
Jamesville, NY 13078-6501 - Phone
- (860) 524-9290
- NPI assigned
- Sep 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A35978 | CA | MD | Adolescent Medicine (Internal Medicine) Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | A35978 | CA | Yes |
Addresses
Primary practice location
4578 Reliant Rd
Jamesville, NY 13078-6501
Mailing address
4578 Reliant Rd
Jamesville, NY 13078-6501
Phone (860) 524-9290
Other providers in Jamesville, NY
- Judith A Hughes
- Integrated Medicine of Syracuse
- Iroquois Nursing Home Inc
- Jamesville Family Medicine and Wellness PC
- Cathy Jaworski
- Kristin Marie Kim
- Susi Koshy
- Ralph B Krutulis
- Alexandra Marie Lanzafame
- Jeannette Marie Lasala
All providers in Jamesville, NY · Adolescent Medicine (Internal Medicine) Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.