Provider Demographics
NPI:1164090502
Name:BHATT, URVI PRAKASHBHAI
Entity Type:Individual
Prefix:
First Name:URVI
Middle Name:PRAKASHBHAI
Last Name:BHATT
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 1:251 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2113
Mailing Address - Country:US
Mailing Address - Phone:940-782-6206
Mailing Address - Fax:
Practice Address - Street 1:410 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4920
Practice Address - Country:US
Practice Address - Phone:718-484-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2022-09-06
Deactivation Date:2022-07-13
Deactivation Code:
Reactivation Date:2022-09-06
Provider Licenses
StateLicense IDTaxonomies
NY045365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist