Basic Information
| Provider Information | |||||||||
| NPI: | 1871947267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAKADIA | ||||||||
| FirstName: | BHAVIKA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 BARD AVE | ||||||||
| Address2: | DEPARTMENT OF MEDICINE VILLA BLDG 1ST FLOOR | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103101664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188182419 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 PATERSON ST STE 6100 | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322357733 | ||||||||
| FaxNumber: | 7322357041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2016 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084V0102X | 25MB10756700 | NJ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.