Provider Demographics
NPI:1073711347
Name:BHARDWAJ, VINAY
Entity Type:Individual
Prefix:DR
First Name:VINAY
Middle Name:
Last Name:BHARDWAJ
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 1:614B PINEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1251
Mailing Address - Country:US
Mailing Address - Phone:732-676-6071
Mailing Address - Fax:732-676-6490
Practice Address - Street 1:300 2ND AVE
Practice Address - Street 2:MONMOUTH MEDICAL CENTER
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6303
Practice Address - Country:US
Practice Address - Phone:888-724-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ06976278208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice