Provider Demographics
NPI:1073587853
Name:BHATT, AZAD V (MD)
Entity Type:Individual
Prefix:DR
First Name:AZAD
Middle Name:V
Last Name:BHATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOSPITAL DR STE C25
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:407-476-4988
Mailing Address - Fax:949-863-6419
Practice Address - Street 1:9120 BALMORAL MEWS SQ STE 505
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6208
Practice Address - Country:US
Practice Address - Phone:856-334-5329
Practice Address - Fax:877-408-7450
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA47582208100000X
FLME58516208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3841502Medicaid
NJ250007174OtherRAIL ROAD MEDICARE
FL0042469Medicaid
NJ574948DJ2Medicare PIN