Provider Demographics
NPI:1396024816
Name:BHATIA, NIRALI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:NIRALI
Middle Name:
Last Name:BHATIA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:NIRALI
Other - Middle Name:T
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52 LADENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2862
Mailing Address - Country:US
Mailing Address - Phone:184-529-0091
Mailing Address - Fax:
Practice Address - Street 1:52 LADENTOWN RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2862
Practice Address - Country:US
Practice Address - Phone:184-529-0091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0110691225X00000X
NJ46TR00551300225X00000X
MA8645225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1102Medicaid
NJ8452900991Medicare PIN
NJ8452900991Medicare NSC
NY8452900991Medicare NSC
NY1102Medicaid