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General NPI Number Information
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NPI Number | 1104926757
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Entity Type | Individual
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Provider Name | BHARGAVI DEVINENI M.D
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Gender | Female
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 7559 263RD ST
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City | GLEN OAKS
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State | NY
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Zip | 11004-1150
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Country | US
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Telephone | 718-470-5770
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Fax |
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Provider Business Mailing Address
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Address Line | 4610 CENTER BLVD APARTMENT # 1918
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City | LONG ISLAND CITY
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State | NY
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Zip | 11109-5826
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 277041
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License Number State | NY
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