Basic Information
| Provider Information | |||||||||
| NPI: | 1831275742 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MITHANI | ||||||||
| FirstName: | BHARATI | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST SW200 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563564935 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 COOPER PLZ | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422425 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2006 | ||||||||
| LastUpdateDate: | 04/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MA38464 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 581506 | 01 | NJ | AMERIHEALTH PPO/ PA BS | OTHER | 60002243 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 1081254 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 2420007 | 05 | NJ | MEDICAID | 2565805 | 01 | NJ | UNITED HEALTHCARE | OTHER | 581506 DLF | 05 | NJ | MEDICAID | 010004098 | 01 | NJ | AMERICHOICE | OTHER | 0403207000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 30091 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 0932683 | 01 | NJ | AETNA | OTHER |