Provider Demographics
NPI:1447208277
Name:MAHANKALI, BHAVANI (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAVANI
Middle Name:
Last Name:MAHANKALI
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 1:5612 217TH ST
Mailing Address - Street 2:FL# 2
Mailing Address - City:BAYSIDE HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1910
Mailing Address - Country:US
Mailing Address - Phone:347-231-7945
Mailing Address - Fax:718-899-0175
Practice Address - Street 1:6519 BORDEN AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1630
Practice Address - Country:US
Practice Address - Phone:718-899-0060
Practice Address - Fax:718-899-0175
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist