Provider Demographics
NPI:1770645772
Name:BHAVSAR, BIPIN J (MD)
Entity type:Individual
Prefix:
First Name:BIPIN
Middle Name:J
Last Name:BHAVSAR
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 1:6289 ROUTE 209
Mailing Address - Street 2:BOX 623
Mailing Address - City:KERHONKSON
Mailing Address - State:NY
Mailing Address - Zip Code:12446-3653
Mailing Address - Country:US
Mailing Address - Phone:845-626-0999
Mailing Address - Fax:
Practice Address - Street 1:6289 ROUTE 209
Practice Address - Street 2:BOX 623
Practice Address - City:KERHONKSON
Practice Address - State:NY
Practice Address - Zip Code:12446-3653
Practice Address - Country:US
Practice Address - Phone:845-626-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129185207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice