Provider Demographics
NPI:1275591497
Name:PADMANABHAN, BHARANIDHARAN (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:BHARANIDHARAN
Middle Name:
Last Name:PADMANABHAN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-2424
Mailing Address - Country:US
Mailing Address - Phone:781-871-3773
Mailing Address - Fax:781-871-3771
Practice Address - Street 1:536 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-2424
Practice Address - Country:US
Practice Address - Phone:781-871-3773
Practice Address - Fax:781-871-3771
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2091682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology