Provider Demographics
NPI:1477842938
Name:BHATTACHARYA, JYOTSNA (MD)
Entity Type:Individual
Prefix:DR
First Name:JYOTSNA
Middle Name:
Last Name:BHATTACHARYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE,
Mailing Address - Street 2:M/S MA. 7.110, PO BOX 5371
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-5005
Mailing Address - Country:US
Mailing Address - Phone:773-320-9969
Mailing Address - Fax:206-987-5060
Practice Address - Street 1:201 50TH AVE APT 17M
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5776
Practice Address - Country:US
Practice Address - Phone:773-320-9969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
NY263165208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program