Provider Demographics
NPI:1871781021
Name:BAWA, HARLEEN (PT)
Entity type:Individual
Prefix:MRS
First Name:HARLEEN
Middle Name:
Last Name:BAWA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3981
Mailing Address - Country:US
Mailing Address - Phone:516-667-4331
Mailing Address - Fax:516-209-3235
Practice Address - Street 1:1165 NORTHERN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3048
Practice Address - Country:US
Practice Address - Phone:516-667-4331
Practice Address - Fax:516-209-3235
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029200-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist