Provider Demographics
NPI:1487895157
Name:BHAVNANI, MEENA A (OTR)
Entity type:Individual
Prefix:MRS
First Name:MEENA
Middle Name:A
Last Name:BHAVNANI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 WHITEHORSE HAMILTON SQUARE RD
Mailing Address - Street 2:SUITE 301, 3 RD FLOOR
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3701
Mailing Address - Country:US
Mailing Address - Phone:609-581-6622
Mailing Address - Fax:609-585-9885
Practice Address - Street 1:1374 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:SUITE 301, 3 RD FLOOR
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3701
Practice Address - Country:US
Practice Address - Phone:609-581-6622
Practice Address - Fax:609-585-9885
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00128800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14702Medicare PIN