1053505131 NPI number — RACHNA BHARTI MD

Table of content: RACHNA BHARTI MD (NPI 1053505131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053505131 NPI number — RACHNA BHARTI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BHARTI
Provider First Name:
RACHNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053505131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 BENWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14214-1761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-986-9199
Provider Business Mailing Address Fax Number:
716-342-2340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
38 HERITAGE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOCKPORT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14094-3616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-478-6655
Provider Business Practice Location Address Fax Number:
716-342-2340
Provider Enumeration Date:
08/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  0101243104 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: N6177 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 0101243104 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 301539 . This is a "NY LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 07762912 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810013447 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080462703 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100047860 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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