Provider Demographics
NPI:1811012842
Name:MHATRE, BEENA VILAS (OTR)
Entity Type:Individual
Prefix:MRS
First Name:BEENA
Middle Name:VILAS
Last Name:MHATRE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-2732
Mailing Address - Country:US
Mailing Address - Phone:609-860-8122
Mailing Address - Fax:609-655-4596
Practice Address - Street 1:292 APPLEGARTH RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3754
Practice Address - Country:US
Practice Address - Phone:609-860-8122
Practice Address - Fax:609-655-4596
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00041000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ46TR00041000OtherOTR LICENSED