Provider Demographics
NPI:1588627186
Name:BHATT, DRUPAD (MD)
Entity Type:Individual
Prefix:DR
First Name:DRUPAD
Middle Name:
Last Name:BHATT
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 1:500 PLAZA CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8262
Mailing Address - Country:US
Mailing Address - Phone:570-422-1400
Mailing Address - Fax:570-476-1518
Practice Address - Street 1:500 PLAZA CT
Practice Address - Street 2:SUITE C
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8262
Practice Address - Country:US
Practice Address - Phone:570-422-1400
Practice Address - Fax:570-476-1518
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038914E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33580Medicare UPIN
PA067792Medicare ID - Type Unspecified