Provider Demographics
NPI:1407888084
Name:BHATT, NISHA (PT, MS)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:BHATT
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 DOUGLAS DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1766
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24 BOOKER ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2619
Practice Address - Country:US
Practice Address - Phone:201-822-0100
Practice Address - Fax:201-822-0107
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA01164100225100000X
NJ40QA01164100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7264733OtherAETNA
NJ0721129OtherCIGNA
NJ098343Medicare ID - Type UnspecifiedPROVIDER NUMBER