Provider Demographics
NPI:1346453842
Name:Y M BHATNAGAR MD INC
Entity Type:Organization
Organization Name:Y M BHATNAGAR MD INC
Other - Org Name:YM BHATNAGAR MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YUDHISHTER
Authorized Official - Middle Name:MOHAN
Authorized Official - Last Name:BHATNAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-849-4611
Mailing Address - Street 1:75 PICKERING ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1243
Mailing Address - Country:US
Mailing Address - Phone:814-849-4611
Mailing Address - Fax:814-849-8746
Practice Address - Street 1:75 PICKERING ST
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1243
Practice Address - Country:US
Practice Address - Phone:814-849-4611
Practice Address - Fax:814-849-8746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018998E261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005873780002Medicaid
PAB34765Medicare UPIN
PA0005873780002Medicaid