Vasanthi Mudradi Prabhu, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA04722900 Issued in NJ

Practice address

151 Knolcroft Rd
New Jersey Health Care System
Lyons, NJ 07939

Phone

(908) 647-0180

Fax

(908) 604-5250

NPI assigned

Aug 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134139801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KNOLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "07939",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KNOLCROFT RD",
            "address_2": "NEW JERSEY HEALTH CARE SYSTEM",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "07939",
            "telephone_number": "908-647-0180",
            "fax_number": "908-604-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "VASANTHI",
        "middle_name": "MUDRADI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04722900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troyshon Phillips, CTRS
• Lisa Cooper Pickett, MSW
• Alan Polnariev
• Harold Popowitz, LCSW
• Marcia A Postallian, NP
• Jennissa Pressley-Burgin
• Nicholas Queune, MSW, LCSW
• Nakima A Rago, PMHNP
• Russell Ramlal
• Kimberly P Rampaul-Pino, AUD, CCC-A

• Internal Medicine Physician in Lyons, NJ
• Providers in Lyons, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.