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General NPI Number Information
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NPI Number | 1114488202
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Entity Type | Individual
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Provider Name | ABHINAV BHALLA M.B.B.S.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 1300 YORK AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10065-4805
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Country | US
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Telephone | 212-746-4352
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 YORK AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10065-4805
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Country | US
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Telephone | 212-746-4352
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 332263
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License Number State | NY
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