Provider Demographics
NPI:1801965769
Name:BHAVNANI, ANITA
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:BHAVNANI
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 1:470A US HIGHWAY 202
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-1559
Mailing Address - Country:US
Mailing Address - Phone:908-781-7171
Mailing Address - Fax:908-781-7172
Practice Address - Street 1:470A US HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-1559
Practice Address - Country:US
Practice Address - Phone:908-781-7171
Practice Address - Fax:908-781-7172
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA56911207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ710879Medicare ID - Type Unspecified
NJE29990Medicare UPIN