Provider Demographics
NPI:1326355561
Name:BHATTI, MURTAZA (DO)
Entity Type:Individual
Prefix:
First Name:MURTAZA
Middle Name:
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 1:367 OLD HOPEWELL RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4331
Mailing Address - Country:US
Mailing Address - Phone:845-243-4996
Mailing Address - Fax:
Practice Address - Street 1:1500 E NEWPORT PIKE STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-2346
Practice Address - Country:US
Practice Address - Phone:845-243-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018824207R00000X
DEC2-0012466207R00000X
NY264826-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03507297Medicaid