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General NPI Number Information
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NPI Number | 1649321720
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Entity Type | Individual
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Provider Name | NAMRATA SANJIV BAVISHI DMD
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 38 BEEKMAN AVE
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2666
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Country | US
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Telephone | 914-631-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 287 NOB HILL DR
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City | ELMSFORD
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State | NY
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Zip | 10523-2433
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Country | US
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Telephone | 914-347-4745
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 50-052544
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License Number State | NY
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