Provider Demographics
NPI:1215576368
Name:BHAVSAR, VAIBHAVI (PHARMD)
Entity Type:Individual
Prefix:
First Name:VAIBHAVI
Middle Name:
Last Name:BHAVSAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LINDSEY CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1526
Mailing Address - Country:US
Mailing Address - Phone:732-725-9549
Mailing Address - Fax:
Practice Address - Street 1:11655 DUENDA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1110
Practice Address - Country:US
Practice Address - Phone:858-385-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03822500183500000X
CA77727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist