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General NPI Number Information
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NPI Number | 1427244276
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Entity Type | Individual
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Provider Name | RAVINDRA KUMAR BHACHAWAT M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 7 WOODBURY FARMS DR
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City | WOODBURY
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State | NY
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Zip | 11797-1242
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Country | US
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Telephone | 631-465-9333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 852
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City | WHEATLEY HEIGHTS
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State | NY
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Zip | 11798-0852
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Country | US
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Telephone | 631-465-9333
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 246300
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License Number State | NY
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