MEDICARE: DR. SUMANKUMAR S BRAHMBHATT MD

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	208100000X	Physical Medicine & Rehabilitation Physician	220437	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962456814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUMANKUMAR S BRAHMBHATT MD

Provider Business Mailing Address
First Line	:	559 ALMENA AVE
Second Line	:
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2133
Country	:	US
Telephone Number	:	914-479-5167
Fax Number	:	914-693-3884

Provider Business Practice Location Address
First Line	:	640 E 233RD ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2802
Country	:	US
Telephone Number	:	718-655-1400
Fax Number	:	718-325-4655

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	05/22/2017

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