Provider Demographics
NPI:1093187270
Name:SONI, BHAVTI
Entity Type:Individual
Prefix:
First Name:BHAVTI
Middle Name:
Last Name:SONI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 TOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-6674
Mailing Address - Country:US
Mailing Address - Phone:908-509-1771
Mailing Address - Fax:908-333-6869
Practice Address - Street 1:112 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2650
Practice Address - Country:US
Practice Address - Phone:908-509-1771
Practice Address - Fax:908-333-6869
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039389225100000X
NJ40QA01732600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist