Healthcare Provider Details

I. General information

NPI: 1780490979
Provider Name (Legal Business Name): PABITRA BHANDARI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 LINDEN AVE FL 8
BALTIMORE MD
21201-4622
US

IV. Provider business mailing address

94-1323 HALEULULAAU ST UNIT A2-71
WAIPAHU HI
96797-6221
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5720
  • Fax:
Mailing address:
  • Phone: 405-314-4202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR199618
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: