Provider Demographics
NPI:1831480581
Name:BHARATAN, RAJITHA (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:RAJITHA
Middle Name:
Last Name:BHARATAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MORGAN ST
Mailing Address - Street 2:APT 11D
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5474
Mailing Address - Country:US
Mailing Address - Phone:203-391-8745
Mailing Address - Fax:
Practice Address - Street 1:95 MORGAN ST
Practice Address - Street 2:APT 11D
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5474
Practice Address - Country:US
Practice Address - Phone:203-391-8745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist