Provider Demographics
NPI:1205243862
Name:BAKHSHI, SHIVANI JATIN (DO)
Entity type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:JATIN
Last Name:BAKHSHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SHIVANI
Other - Middle Name:JATIN
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:51 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2640
Mailing Address - Country:US
Mailing Address - Phone:215-662-9801
Mailing Address - Fax:215-243-3249
Practice Address - Street 1:51 N 39TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:215-662-9801
Practice Address - Fax:215-243-3249
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10150200207RH0003X
PAOS022429207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology