Provider Demographics
NPI:1619989639
Name:BHASIN, ATUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ATUL
Middle Name:
Last Name:BHASIN
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 1:8 BARCLAY ST
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1005
Mailing Address - Country:US
Mailing Address - Phone:732-637-8444
Mailing Address - Fax:732-637-8440
Practice Address - Street 1:1001 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2579
Practice Address - Country:US
Practice Address - Phone:732-637-8444
Practice Address - Fax:732-637-8440
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08006600207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
099427Medicare ID - Type Unspecified
H72139Medicare UPIN