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NPI Code Detail

MEDICARE: DR. BHARGAVI DEVINENI M.D

MEDICARE: DR. BHARGAVI DEVINENI 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
12084P0800XPsychiatry Physician277041NY

General Provider Information

NPI Number : 1104926757
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BHARGAVI DEVINENI M.D
Provider Business Mailing Address
First Line : 4610 CENTER BLVD
Second Line : APARTMENT # 1918
City : LONG ISLAND CITY
State : NY
Zip : 11109-5826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7559 263RD ST
Second Line :
City : GLEN OAKS
State : NY
Zip : 11004-1150
Country : US
Telephone Number : 718-470-5770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2006
Last Update Date : 11/10/2014

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