MEDICARE: SUBBARAO BHIMANI 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	2084N0400X	Neurology Physician	237173	NY

General Provider Information

NPI Number	:	1164482444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUBBARAO BHIMANI M.D.

Provider Business Mailing Address
First Line	:	4230 HEMPSTEAD TPKE
Second Line	:	SUITE 106
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5700
Country	:	US
Telephone Number	:	516-520-5507
Fax Number	:	631-271-9155

Provider Business Practice Location Address
First Line	:	4230 HEMPSTEAD TPKE
Second Line	:	SUITE 106
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5700
Country	:	US
Telephone Number	:	516-520-5507
Fax Number	:	631-271-9155

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	08/03/2010

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