Provider Demographics
NPI:1487114666
Name:BHENSWALA, PRASHANT (MD, MSCR)
Entity type:Individual
Prefix:DR
First Name:PRASHANT
Middle Name:
Last Name:BHENSWALA
Suffix:
Gender:M
Credentials:MD, MSCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3450
Mailing Address - Country:US
Mailing Address - Phone:631-422-0205
Mailing Address - Fax:
Practice Address - Street 1:250 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3415
Practice Address - Country:US
Practice Address - Phone:631-422-0205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318484207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology