Provider Demographics
NPI:1689948705
Name:BHARWANI, SAMEER B (PT)
Entity Type:Individual
Prefix:MR
First Name:SAMEER
Middle Name:B
Last Name:BHARWANI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 BAINBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1411
Mailing Address - Country:US
Mailing Address - Phone:718-652-3535
Mailing Address - Fax:718-652-2323
Practice Address - Street 1:3555 BAINBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1411
Practice Address - Country:US
Practice Address - Phone:718-652-3535
Practice Address - Fax:718-652-2323
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY034348-1OtherPT LICENSE