Provider Demographics
NPI:1598783953
Name:BHATTI, AHMAD F (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:F
Last Name:BHATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:620 BELLE TERRE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2500
Mailing Address - Country:US
Mailing Address - Phone:631-524-5960
Mailing Address - Fax:631-524-5963
Practice Address - Street 1:620 BELLE TERRE RD
Practice Address - Street 2:SUITE #2
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2500
Practice Address - Country:US
Practice Address - Phone:631-524-5960
Practice Address - Fax:631-524-5963
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221708-12086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2217081OtherLICENSE