Provider Demographics
NPI:1841414000
Name:MOHANDAS, BHAVNA (MD)
Entity Type:Individual
Prefix:
First Name:BHAVNA
Middle Name:
Last Name:MOHANDAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MARKET ST FL 30
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-2934
Mailing Address - Country:US
Mailing Address - Phone:215-481-6836
Mailing Address - Fax:215-481-3985
Practice Address - Street 1:60 EVERGREEN PL STE 400
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2120
Practice Address - Country:US
Practice Address - Phone:973-395-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6722207R00000X
PAMD447514207R00000X, 207RC0000X, 207R00000X
NJ25MA09530100207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine