MEDICARE: BHAVANA R JAPI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	219891	NY

General Provider Information

NPI Number	:	1023034295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAVANA R JAPI M.D.

Provider Business Mailing Address
First Line	:	4 DALLAS AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-3913
Country	:	US
Telephone Number	:	516-437-5356
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1716
Country	:	US
Telephone Number	:	718-235-0222
Fax Number	:	718-235-1811

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	12/05/2011

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