Provider Demographics
NPI:1194486332
Name:BHAGAT, SUNITA KUMARY (RN)
Entity type:Individual
Prefix:
First Name:SUNITA
Middle Name:KUMARY
Last Name:BHAGAT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 58TH AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5166
Mailing Address - Country:US
Mailing Address - Phone:573-200-5257
Mailing Address - Fax:
Practice Address - Street 1:9430 60TH AVE APT 6K
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5083
Practice Address - Country:US
Practice Address - Phone:573-200-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-09
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF352688-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty