Provider Demographics
NPI:1225532575
Name:BHANA, RUPAL
Entity type:Individual
Prefix:
First Name:RUPAL
Middle Name:
Last Name:BHANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MINEOLA BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4077
Mailing Address - Country:US
Mailing Address - Phone:516-294-5440
Mailing Address - Fax:516-294-1206
Practice Address - Street 1:120 MINEOLA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4077
Practice Address - Country:US
Practice Address - Phone:516-294-5440
Practice Address - Fax:516-294-1206
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316965207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology