Provider Demographics
NPI:1932893096
Name:BHAVSAR, DIPAL
Entity Type:Individual
Prefix:
First Name:DIPAL
Middle Name:
Last Name:BHAVSAR
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 1:631 ROUTE 9 S
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-4031
Mailing Address - Country:US
Mailing Address - Phone:609-296-7858
Mailing Address - Fax:609-296-7929
Practice Address - Street 1:631 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-4031
Practice Address - Country:US
Practice Address - Phone:609-296-7858
Practice Address - Fax:609-296-7929
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00390300156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician