Basic Information
| Provider Information | |||||||||
| NPI: | 1629021746 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRABHU | ||||||||
| FirstName: | BHAKTI | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 97 GREENWICH AVE | ||||||||
| Address2: | C/O EQUINOX 3RD FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100145203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127419288 | ||||||||
| FaxNumber: | 2127416826 | ||||||||
| Practice Location | |||||||||
| Address1: | 97 GREENWICH AVE | ||||||||
| Address2: | C/O EQUINOX 3RD FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100145203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127419288 | ||||||||
| FaxNumber: | 2127416826 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 27242 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.