Healthcare Provider Details

I. General information

NPI: 1477560324
Provider Name (Legal Business Name): ABHA BHARGAVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PERRINE RD SUITE 206
OLD BRIDGE NJ
08857-2842
US

IV. Provider business mailing address

21 EXETER DR
MARLBORO NJ
07746-2732
US

V. Phone/Fax

Practice location:
  • Phone: 732-316-5100
  • Fax: 732-761-9179
Mailing address:
  • Phone: 732-316-5100
  • Fax: 732-761-9179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMA64691
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: