Provider Demographics
NPI:1275578601
Name:OJHA, BHAWANI S (MD)
Entity Type:Individual
Prefix:
First Name:BHAWANI
Middle Name:S
Last Name:OJHA
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 1:412 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1834
Mailing Address - Country:US
Mailing Address - Phone:860-563-3841
Mailing Address - Fax:
Practice Address - Street 1:412 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1834
Practice Address - Country:US
Practice Address - Phone:860-563-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001350082Medicaid
CT001350082Medicaid
CT110007861Medicare ID - Type Unspecified