Provider Demographics
NPI:1063830008
Name:BHATT, UPASANA S
Entity Type:Individual
Prefix:
First Name:UPASANA
Middle Name:S
Last Name:BHATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SWEET BRIAR DR APT 24
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2026
Mailing Address - Country:US
Mailing Address - Phone:845-542-0523
Mailing Address - Fax:
Practice Address - Street 1:72 SWEET BRIAR DR APT 24
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2026
Practice Address - Country:US
Practice Address - Phone:845-542-0523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-06
Last Update Date:2014-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03623300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist