Pranav Raghunath Prabhu, PA
Physician Assistant, Medical in Rochester, NY. Individual provider (NPI-1).
NPI number1972850436
StatusActive
Last updated in NPPESJun 30, 2023
Details
- NPI
- 1972850436
- Entity type
- Individual (NPI-1)
- Name
- Pranav Raghunath Prabhu
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 14, 2012
- Last updated
- Jun 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 015786 | NY | Yes |
| 363AM0700X | Physician Assistant, Medical | 15786 | NY |
Practice location
1555 Long Pond RdDepartment Of Medicine
Rochester, NY 14626-4122
Phone 585-723-7870 · Fax 585-723-7871
Mailing address
1555 Long Pond RdDepartment Of Medicine
Rochester, NY 14626-4122
Phone 585-723-7870 · Fax 585-723-7871
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