Provider Demographics
NPI:1831275742
Name:MITHANI, BHARATI T (MD)
Entity type:Individual
Prefix:
First Name:BHARATI
Middle Name:T
Last Name:MITHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4935
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA38464207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ581506OtherAMERIHEALTH PPO/ PA BS
NJ60002243OtherHORIZON NJ HEALTH
NJ1081254OtherHORIZON NJ HEALTH
NJ2420007Medicaid
NJ2565805OtherUNITED HEALTHCARE
NJ581506 DLFMedicaid
NJ010004098OtherAMERICHOICE
NJ0403207000OtherAMERIHEALTH/KEYSTONE/IBC
NJ30091OtherUNIVERSITY HEALTH PLAN
NJ0932683OtherAETNA
E53552Medicare UPIN
NJ581506 DLFMedicaid
NJ010004098OtherAMERICHOICE
NJ1081254OtherHORIZON NJ HEALTH