Provider Demographics
NPI:1467879742
Name:BHATT, JAYANT
Entity Type:Individual
Prefix:
First Name:JAYANT
Middle Name:
Last Name:BHATT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WASHINGTON ST
Mailing Address - Street 2:APT 612
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4572
Mailing Address - Country:US
Mailing Address - Phone:201-650-1446
Mailing Address - Fax:
Practice Address - Street 1:155 WASHINGTON ST
Practice Address - Street 2:APT 612
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4572
Practice Address - Country:US
Practice Address - Phone:201-650-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist