Provider Demographics
NPI:1902238884
Name:MADHAVI P LLC
Entity Type:Organization
Organization Name:MADHAVI P LLC
Other - Org Name:MADHAVI PRASAD, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADHAVI S.V.
Authorized Official - Middle Name:
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-847-9012
Mailing Address - Street 1:425 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1237
Mailing Address - Country:US
Mailing Address - Phone:774-847-9012
Mailing Address - Fax:774-847-9736
Practice Address - Street 1:851 MIDDLE ST STE 3300
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1779
Practice Address - Country:US
Practice Address - Phone:774-847-9012
Practice Address - Fax:774-847-9736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235783208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty