Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 281484 | NY |
NPI | 1033436019 |
---|---|
Provider Name | Dr. Dhaval Bhanusali |
First Address | New York, NY 10018-9737 |
Second Address | New York, NY 10018-9737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 10/10/2019 |