Provider Demographics
NPI:1346397676
Name:BATHEJA, NEHA (PA)
Entity Type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:BATHEJA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 EAST WINTONBURY AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3119
Mailing Address - Country:US
Mailing Address - Phone:516-343-3866
Mailing Address - Fax:
Practice Address - Street 1:24 EAST WINTONBURY AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3119
Practice Address - Country:US
Practice Address - Phone:516-343-3866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001874363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical