Provider Demographics
NPI:1366502163
Name:BHALLA, ANSHU (MD)
Entity type:Individual
Prefix:DR
First Name:ANSHU
Middle Name:
Last Name:BHALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5 PLAINSBORO ROAD
Mailing Address - Street 2:MEDICAL ARTS PAVILION, SUITE 300
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1915
Mailing Address - Country:US
Mailing Address - Phone:609-954-3084
Mailing Address - Fax:
Practice Address - Street 1:5 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 275
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1915
Practice Address - Country:US
Practice Address - Phone:609-954-3084
Practice Address - Fax:609-860-5288
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08180400207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI67162Medicare UPIN