Provider Demographics
NPI:1508969924
Name:BHAVNANI, SANGEETA S
Entity Type:Individual
Prefix:DR
First Name:SANGEETA
Middle Name:S
Last Name:BHAVNANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9185 LEDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-4024
Mailing Address - Country:US
Mailing Address - Phone:440-740-0457
Mailing Address - Fax:
Practice Address - Street 1:10000 BRECKSVILLE ROAD
Practice Address - Street 2:VA MEDICAL CENTER PRIMARY CARE
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141
Practice Address - Country:US
Practice Address - Phone:440-526-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072168B207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine