Healthcare Provider Details

I. General information

NPI: 1437748936
Provider Name (Legal Business Name): ANAND BRAHMBHATT PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W BOWERY ST
AKRON OH
44308-1069
US

IV. Provider business mailing address

1551 RIVERSIDE DR
LAKEWOOD OH
44107-3571
US

V. Phone/Fax

Practice location:
  • Phone: 201-988-6149
  • Fax:
Mailing address:
  • Phone: 201-988-6149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0028301
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberIR.967585
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number240742
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: