Provider Demographics
NPI:1376325522
Name:BAJRACHARYA, BINDIYA
Entity Type:Individual
Prefix:
First Name:BINDIYA
Middle Name:
Last Name:BAJRACHARYA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BINDIYA
Other - Middle Name:
Other - Last Name:BAJRACHARYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2188 SNOWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:MENTONE
Mailing Address - State:CA
Mailing Address - Zip Code:92359-9533
Mailing Address - Country:US
Mailing Address - Phone:954-303-5988
Mailing Address - Fax:
Practice Address - Street 1:2188 SNOWBERRY LN
Practice Address - Street 2:
Practice Address - City:MENTONE
Practice Address - State:CA
Practice Address - Zip Code:92359-9533
Practice Address - Country:US
Practice Address - Phone:954-303-5988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95025659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily