MEDICARE: ALPESHKUMAR BAVISHI 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	25MA08782800	NJ
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25MA08782800	NJ
3	207RP1001X	Pulmonary Disease Physician	25MA08782800	NJ

General Provider Information

NPI Number	:	1790008787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALPESHKUMAR BAVISHI M.D.

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-273-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 MILLBURN AVE STE 200A
Second Line	:
City	:	MILLBURN
State	:	NJ
Zip	:	07041-1941
Country	:	US
Telephone Number	:	973-763-6800
Fax Number	:	973-763-1255

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

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	12/12/2022

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