Provider Demographics
NPI:1568693661
Name:BHATIA, VAIBHAV (MD)
Entity Type:Individual
Prefix:DR
First Name:VAIBHAV
Middle Name:
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7559 263RD ST
Mailing Address - Street 2:
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1150
Mailing Address - Country:US
Mailing Address - Phone:718-470-8228
Mailing Address - Fax:718-831-0368
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-8228
Practice Address - Fax:718-831-0368
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2576542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry