Provider Demographics
NPI:1003400789
Name:BHATWALA, HARSHIT SUNILKUMAR
Entity Type:Individual
Prefix:MR
First Name:HARSHIT
Middle Name:SUNILKUMAR
Last Name:BHATWALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 BEACH 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3625
Mailing Address - Country:US
Mailing Address - Phone:718-337-2727
Mailing Address - Fax:
Practice Address - Street 1:265 BEACH 20TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3625
Practice Address - Country:US
Practice Address - Phone:718-337-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2022-03-30
Deactivation Date:2022-02-21
Deactivation Code:
Reactivation Date:2022-03-30
Provider Licenses
StateLicense IDTaxonomies
NY046878225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist