Individual
MRS. BHOOMI D THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
88 PARK AVE STE 2A, NUTLEY, NJ 07110-3500
(973) 571-2121
Mailing address
147 E QUACKENBUSH AVE, DUMONT, NJ 07628-3037
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
023238-1
NY
363A00000X
Physician Assistant
Primary
36790
NJ
Other
Enumeration date
03/08/2019
Last updated
04/30/2022
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