Provider Demographics
NPI:1376921510
Name:SARKAR, BHASKAR
Entity Type:Individual
Prefix:
First Name:BHASKAR
Middle Name:
Last Name:SARKAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 EVANS ST
Mailing Address - Street 2:APT B18
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 EVANS ST
Practice Address - Street 2:APT B18
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4615
Practice Address - Country:US
Practice Address - Phone:704-787-4472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP15244225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist