Provider Demographics
NPI:1295720688
Name:BHARNE, DILIP (MD)
Entity type:Individual
Prefix:
First Name:DILIP
Middle Name:
Last Name:BHARNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25137 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1731
Mailing Address - Country:US
Mailing Address - Phone:718-631-5082
Mailing Address - Fax:
Practice Address - Street 1:25137 51ST AVE
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1731
Practice Address - Country:US
Practice Address - Phone:718-631-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1338122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00279043Medicaid
NY00279043Medicaid
B13551Medicare UPIN