Healthcare Provider Details

I. General information

NPI: 1003573221
Provider Name (Legal Business Name): NIRALI S. BHAVSAR APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIVERFRONT PLZ STE 300
NEWARK NJ
07102-5412
US

IV. Provider business mailing address

8 W HENRY PL
ISELIN NJ
08830-1104
US

V. Phone/Fax

Practice location:
  • Phone: 201-273-7047
  • Fax: 855-998-4358
Mailing address:
  • Phone: 732-491-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01229200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: