1285668871 NPI number — ANIS BHATTY MD

Table of content: ANIS BHATTY MD (NPI 1285668871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285668871 NPI number — ANIS BHATTY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BHATTY
Provider First Name:
ANIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1285668871
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 BROADWAY
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
ELMWOOD PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07407-1842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-794-8855
Provider Business Mailing Address Fax Number:
201-794-6988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
ELMWOOD PARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07407-1842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-794-8855
Provider Business Practice Location Address Fax Number:
201-794-6988
Provider Enumeration Date:
07/10/2006

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: 208000000X , with the licence number:  MA40211 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 317521 . This is a "EMPIRE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000452700 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0984697004 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: OK2765 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: PP071 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1028441 . This is a "HORIZON MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 184090801 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: J5146 . This is a "HORIZON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4197029 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 510452 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 10832 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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