Provider Demographics
NPI:1710300421
Name:SUBBARAO BHIMANI MD PC
Entity Type:Organization
Organization Name:SUBBARAO BHIMANI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-465-9333
Mailing Address - Street 1:998 OLD COUNTRY RD STE C
Mailing Address - Street 2:STE 284
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4936
Mailing Address - Country:US
Mailing Address - Phone:631-465-9333
Mailing Address - Fax:631-465-9333
Practice Address - Street 1:998 OLD COUNTRY RD STE C
Practice Address - Street 2:STE 284
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4936
Practice Address - Country:US
Practice Address - Phone:631-465-9333
Practice Address - Fax:631-465-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2371732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty