Provider Demographics
NPI:1629021746
Name:PRABHU, BHAKTI (PT)
Entity Type:Individual
Prefix:
First Name:BHAKTI
Middle Name:
Last Name:PRABHU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 GREENWICH AVE
Mailing Address - Street 2:C/O EQUINOX 3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-5203
Mailing Address - Country:US
Mailing Address - Phone:212-741-9288
Mailing Address - Fax:212-741-6826
Practice Address - Street 1:97 GREENWICH AVE
Practice Address - Street 2:C/O EQUINOX 3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5203
Practice Address - Country:US
Practice Address - Phone:212-741-9288
Practice Address - Fax:212-741-6826
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist