Provider Demographics
NPI:1619282795
Name:BHATIA, JASMINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:
Last Name:BHATIA
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 1:50 ROUTE 25A
Mailing Address - Street 2:EMPLOYEE SERVICES BLDG
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787
Mailing Address - Country:US
Mailing Address - Phone:631-862-3413
Mailing Address - Fax:631-862-3604
Practice Address - Street 1:50 ROUTE 25A
Practice Address - Street 2:EMPLOYEE SERVICES BLDG
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-862-3413
Practice Address - Fax:631-862-3604
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257812-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology