Provider Demographics
NPI:1467427807
Name:BHATTACHARYA, ASHISH K (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:K
Last Name:BHATTACHARYA
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 1:55 SCHANCK RD
Mailing Address - Street 2:STE-A4
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2964
Mailing Address - Country:US
Mailing Address - Phone:732-683-1033
Mailing Address - Fax:732-683-2477
Practice Address - Street 1:55 SCHANCK RD
Practice Address - Street 2:STE-A4
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2964
Practice Address - Country:US
Practice Address - Phone:732-683-1033
Practice Address - Fax:732-683-2477
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA057831174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG51120Medicare UPIN
NJ952804Medicare ID - Type Unspecified