Provider Demographics
NPI:1013003417
Name:HARISH K BHATT, MD, PA
Entity Type:Organization
Organization Name:HARISH K BHATT, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-753-6522
Mailing Address - Street 1:3 MARTHA ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-4404
Mailing Address - Country:US
Mailing Address - Phone:908-753-6522
Mailing Address - Fax:908-663-2634
Practice Address - Street 1:3 MARTHA ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-4404
Practice Address - Country:US
Practice Address - Phone:908-753-6522
Practice Address - Fax:908-663-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05411400208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ058945Medicare ID - Type Unspecified