Provider Demographics
NPI:1417236779
Name:BHAMBHANI, DRALIPADI (MD)
Entity Type:Individual
Prefix:MRS
First Name:DRALIPADI
Middle Name:
Last Name:BHAMBHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50-41, 186TH STREET
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1610
Mailing Address - Country:US
Mailing Address - Phone:718-357-6921
Mailing Address - Fax:
Practice Address - Street 1:50-41, 186TH STREET
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1610
Practice Address - Country:US
Practice Address - Phone:718-357-6921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121358-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE56354Medicare UPIN