Provider Demographics
NPI:1316133457
Name:RITU BHAMBHANI LLC
Entity type:Organization
Organization Name:RITU BHAMBHANI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RITU
Authorized Official - Middle Name:T
Authorized Official - Last Name:BHAMBHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-857-1417
Mailing Address - Street 1:100 WALTER WARD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1284
Mailing Address - Country:US
Mailing Address - Phone:410-777-8971
Mailing Address - Fax:877-595-7180
Practice Address - Street 1:100 WALTER WARD BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1284
Practice Address - Country:US
Practice Address - Phone:410-569-3333
Practice Address - Fax:877-595-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056138174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD132702000Medicaid
MD6285230002Medicare NSC
MD132702000Medicaid