Provider Demographics
NPI:1053282871
Name:BHAKTA, RISHA PRADIP
Entity type:Individual
Prefix:
First Name:RISHA
Middle Name:PRADIP
Last Name:BHAKTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 TASKER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1019
Mailing Address - Country:US
Mailing Address - Phone:215-271-4100
Mailing Address - Fax:215-271-1785
Practice Address - Street 1:1208 TASKER ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-1019
Practice Address - Country:US
Practice Address - Phone:215-271-4100
Practice Address - Fax:215-271-1785
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT033522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist