Provider Demographics
NPI:1033147483
Name:BHATT, UDAY N (MD)
Entity Type:Individual
Prefix:DR
First Name:UDAY
Middle Name:N
Last Name:BHATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2111 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3403
Mailing Address - Country:US
Mailing Address - Phone:609-587-6070
Mailing Address - Fax:609-587-6010
Practice Address - Street 1:2111 KLOCKNER RD
Practice Address - Street 2:NJ SPINE AND PAIN CENTER
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-587-6070
Practice Address - Fax:609-587-6010
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08013000208100000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ172023Medicare UPIN
NJ121949Medicare PIN