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NPI 1023038957

NPI 1023038957 : BHARATHI V BONTHU M.D. : MIDDLETOWN, NY

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General NPI Number Information
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    NPI Number           |    1023038957
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    Entity Type          |    Individual 
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    Provider Name        |    BHARATHI V BONTHU M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/21/2006
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    Last Update Date     |    01/28/2025
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Provider Practice Location Address
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    Address Line         |    10 BENTON AVE 
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    City                 |    MIDDLETOWN
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    State                |    NY
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    Zip                  |    10940-5177
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    Country              |    US
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    Telephone            |    845-563-8000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2570 ROUTE 9W STE 10 
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    City                 |    CORNWALL
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    State                |    NY
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    Zip                  |    12518-1370
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    Country              |    US
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    Telephone            |    845-220-3100
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    Fax                  |    845-534-2940
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    239181
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    228006
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    License Number State |    MA
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