Provider Demographics
NPI:1083807242
Name:SHARMA, BHAVESH P (PT)
Entity Type:Individual
Prefix:MR
First Name:BHAVESH
Middle Name:P
Last Name:SHARMA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 ANDREW AVE
Mailing Address - Street 2:APT. 272
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-4356
Mailing Address - Country:US
Mailing Address - Phone:203-980-3323
Mailing Address - Fax:
Practice Address - Street 1:151 ANDREW AVE
Practice Address - Street 2:APT. 272
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4356
Practice Address - Country:US
Practice Address - Phone:203-980-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist