Provider Demographics
NPI:1295589760
Name:BHAKTA, SNEH SANJAY (PT, DPT)
Entity type:Individual
Prefix:
First Name:SNEH
Middle Name:SANJAY
Last Name:BHAKTA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4903 EDGEMOOR LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5342
Mailing Address - Country:US
Mailing Address - Phone:952-356-6509
Mailing Address - Fax:
Practice Address - Street 1:5272 MD-190
Practice Address - Street 2:SUITE 350
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816
Practice Address - Country:US
Practice Address - Phone:240-686-5609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD298552251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports