Provider Demographics
NPI:1972618643
Name:PANDIT, BHARATHI S (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARATHI
Middle Name:S
Last Name:PANDIT
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:PO BOX 2490
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70073-2490
Mailing Address - Country:US
Mailing Address - Phone:504-762-8900
Mailing Address - Fax:504-328-0899
Practice Address - Street 1:4028 U.S.HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:LA
Practice Address - Zip Code:70094-2622
Practice Address - Country:US
Practice Address - Phone:504-762-8900
Practice Address - Fax:504-328-0899
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP2001155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1720356Medicaid
LAP00426582OtherMEDICARE RAILROAD
LA1656828Medicaid
LA1656828Medicaid
LAP00426582OtherMEDICARE RAILROAD
LA1720356Medicaid