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General NPI Number Information
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NPI Number | 1851923700
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Entity Type | Individual
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Provider Name | SHREYA RAJEEV BHAMBURE DMD
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Gender | Female
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Dates
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Enumeration Date | 02/09/2020
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Last Update Date | 02/09/2020
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Provider Practice Location Address
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Address Line | 938 HUDSON ST
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City | HOBOKEN
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State | NJ
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Zip | 07030-5149
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Country | US
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Telephone | 201-234-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 100 DUDLEY ST APT 2211
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City | JERSEY CITY
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State | NJ
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Zip | 07302-6446
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Country | US
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Telephone | 201-899-1238
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02788300
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License Number State | NJ
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