Provider Demographics
NPI:1457089450
Name:MAHESWARAN, BHAVANI
Entity Type:Individual
Prefix:
First Name:BHAVANI
Middle Name:
Last Name:MAHESWARAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 EDISON GLEN TER BLDG 1
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2921
Mailing Address - Country:US
Mailing Address - Phone:929-939-7130
Mailing Address - Fax:
Practice Address - Street 1:516 STRAND STREET,FREDERIKSTED
Practice Address - Street 2:
Practice Address - City:ST.CROIX
Practice Address - State:VI
Practice Address - Zip Code:00840
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program