Provider Demographics
NPI:1528042124
Name:PHADKE, BHARATI JAYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARATI
Middle Name:JAYANT
Last Name:PHADKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 LONG DR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3639
Mailing Address - Country:US
Mailing Address - Phone:508-836-8937
Mailing Address - Fax:
Practice Address - Street 1:20 WORCESTER CENTER BLVD
Practice Address - Street 2:WORCESTER MEDICAL CENTER, STE 585
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1312
Practice Address - Country:US
Practice Address - Phone:508-363-9030
Practice Address - Fax:508-363-9037
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA803252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3140890Medicaid
MAJ14867Medicare ID - Type UnspecifiedPHYSICIAN PROVIDER NUMBER
MA3140890Medicaid