Provider Demographics
NPI:1215016431
Name:BHATT, ANJANI (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJANI
Middle Name:
Last Name:BHATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2709
Mailing Address - Country:US
Mailing Address - Phone:516-889-8853
Mailing Address - Fax:516-889-8857
Practice Address - Street 1:871 E PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2709
Practice Address - Country:US
Practice Address - Phone:516-889-8853
Practice Address - Fax:516-889-8857
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145992207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY21D631Medicare ID - Type Unspecified