Basic Information
| Provider Information | |||||||||
| NPI: | 1306936604 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMPRASAD | ||||||||
| FirstName: | VATSALA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 MEDICAL CENTER BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190133955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106197410 | ||||||||
| FaxNumber: | 6108768483 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 MEDICAL CENTER BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190133955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106197410 | ||||||||
| FaxNumber: | 6108768483 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2006 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0214X | MED-PHYS-LIC-117000 | MT | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | 2080P0214X | MD038724L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | 2080P0214X | MA45263 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology |
ID Information
| ID | Type | State | Issuer | Description | 3K5981 | 01 | NJ | HEALTHNET | OTHER | 24742 | 01 | NH | UNIVERSITY HEALTH PLAN | OTHER | 754942 | 01 | NJ | UNITED HEALTHCARE | OTHER | 1127080 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 4266442 | 01 | NJ | CIGNA | OTHER | P2117185 | 01 | NJ | OXFORD | OTHER | 010003847 | 01 | NJ | AMERICHOICE | OTHER | 2969235 | 01 | NJ | AETNA | OTHER | 348668 | 01 | NJ | AMERIHEALTH PPO/PA BS | OTHER | 0766874000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 2497000 | 05 | NJ | MEDICAID |