Provider Demographics
NPI:1821509738
Name:SREERENJINI, BHAGYA LAKSHMI THANKAN
Entity Type:Individual
Prefix:
First Name:BHAGYA LAKSHMI
Middle Name:THANKAN
Last Name:SREERENJINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 FINNEGAN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1061
Mailing Address - Country:US
Mailing Address - Phone:732-758-8971
Mailing Address - Fax:
Practice Address - Street 1:1503 FINNEGAN LN
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1061
Practice Address - Country:US
Practice Address - Phone:732-758-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172M00000XOther Service ProvidersMechanotherapist
No173C00000XOther Service ProvidersReflexologist