Provider Demographics
NPI:1528126455
Name:BHAGAT, DHIRUBHAI N (RPH)
Entity type:Individual
Prefix:MR
First Name:DHIRUBHAI
Middle Name:N
Last Name:BHAGAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2049
Mailing Address - Country:US
Mailing Address - Phone:914-969-7741
Mailing Address - Fax:914-969-4174
Practice Address - Street 1:358 S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2049
Practice Address - Country:US
Practice Address - Phone:914-969-7741
Practice Address - Fax:914-969-4174
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01242048Medicaid
NY5253520001Medicare ID - Type Unspecified