Provider Demographics
NPI:1518712066
Name:BRAHMBHATT, SUHANI (PA-C)
Entity Type:Individual
Prefix:
First Name:SUHANI
Middle Name:
Last Name:BRAHMBHATT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 GREEN HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-2863
Mailing Address - Country:US
Mailing Address - Phone:770-298-8991
Mailing Address - Fax:
Practice Address - Street 1:2436 GREEN HOLLOW CT
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-2863
Practice Address - Country:US
Practice Address - Phone:770-298-8991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical