Provider Demographics
NPI:1043598352
Name:BHATTI, HAMZA DASTGIR (DO)
Entity Type:Individual
Prefix:DR
First Name:HAMZA
Middle Name:DASTGIR
Last Name:BHATTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DOHNE CT
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1516
Mailing Address - Country:US
Mailing Address - Phone:631-965-1700
Mailing Address - Fax:
Practice Address - Street 1:1727 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5214
Practice Address - Country:US
Practice Address - Phone:212-489-6669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15873207ND0101X, 207ND0101X
NJ25MB09502300207ND0101X, 207N00000X
PAOS020863207ND0101X
CA20A18457207ND0101X, 207ND0101X
NY272143207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology