Provider Demographics
NPI:1174537153
Name:KANTHARIA, BHARAT K (MD)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:K
Last Name:KANTHARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W 60TH ST APT 1U
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7906
Mailing Address - Country:US
Mailing Address - Phone:212-757-7100
Mailing Address - Fax:212-757-7102
Practice Address - Street 1:30 W 60TH ST APT 1U
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7906
Practice Address - Country:US
Practice Address - Phone:212-757-7100
Practice Address - Fax:212-757-7102
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2015-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0151207RC0000X, 207RC0001X
NY250646207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2608806Medicaid
TX2608806Medicaid
TX349190ZGMSOtherMEDICARE ID
NY04009936Medicaid
NYA100111711OtherMEDICARE ID
NYA100111711OtherMEDICARE ID
OH2608806Medicaid
NY04009936Medicaid