Basic Information
| Provider Information | |||||||||
| NPI: | 1871197236 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHATNAGAR | ||||||||
| FirstName: | ASTHA | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 OLD SHORT HILLS RD APT 363 | ||||||||
| Address2: | |||||||||
| City: | WEST ORANGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070521037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165332379 | ||||||||
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| Practice Location | |||||||||
| Address1: | 33 MATEO AVE | ||||||||
| Address2: | |||||||||
| City: | MILLBRAE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940302037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506895784 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2020 | ||||||||
| LastUpdateDate: | 11/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 299274 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.