Basic Information
Provider Information
NPI: 1902048812
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BHAVE
FirstName: MANASI
MiddleName: AMIT
NamePrefix: MRS.
NameSuffix:  
Credential: M.S.(O.T.)
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 380 DEMOTT LN
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088732762
CountryCode: US
TelephoneNumber: 7328732000
FaxNumber:  
Practice Location
Address1: 380 DEMOTT LN
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088732762
CountryCode: US
TelephoneNumber: 7328732000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/24/2009
LastUpdateDate: 03/24/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X46TR00489400NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


Home