1164478210 NPI number — APURVA BHATT

Table of content: APURVA BHATT (NPI 1164478210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164478210 NPI number — APURVA BHATT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BHATT
Provider First Name:
APURVA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164478210
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 WILLOW ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERLIN
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03570-2084
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-752-3669
Provider Business Mailing Address Fax Number:
603-752-3027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 PLEASANT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERLIN
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03570-2006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-752-2040
Provider Business Practice Location Address Fax Number:
603-752-7797
Provider Enumeration Date:
05/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  LT-2465 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LT-2465 . This is a "STATE LICENSE #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 95Y003435NH01 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 020350051 . This is a "FEDERAL TAX ID #" identifier . This identifiers is of the category "OTHER".