Provider Demographics
NPI:1295935260
Name:BAWANGAONWALA, ZEENAT (BPT)
Entity type:Individual
Prefix:MRS
First Name:ZEENAT
Middle Name:
Last Name:BAWANGAONWALA
Suffix:
Gender:F
Credentials:BPT
Other - Prefix:MISS
Other - First Name:ZEENAT
Other - Middle Name:
Other - Last Name:ARIF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7621 BRAELANDS DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9363
Mailing Address - Country:US
Mailing Address - Phone:443-745-6822
Mailing Address - Fax:
Practice Address - Street 1:7621 BRAELANDS DR
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9363
Practice Address - Country:US
Practice Address - Phone:443-745-6822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC250226Medicare PIN
NC0198770001Medicare NSC