Provider Demographics
NPI:1790583490
Name:BHAVE, RUJUTA MAYUR
Entity type:Individual
Prefix:
First Name:RUJUTA
Middle Name:MAYUR
Last Name:BHAVE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 NEWTOWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4317
Mailing Address - Country:US
Mailing Address - Phone:516-802-2518
Mailing Address - Fax:516-644-5471
Practice Address - Street 1:245 NEWTOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4317
Practice Address - Country:US
Practice Address - Phone:516-802-2518
Practice Address - Fax:516-644-5471
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539972081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine