Provider Demographics
NPI:1689869844
Name:BHARDWAJ, VATSALA (MD, PHD)
Entity Type:Individual
Prefix:
First Name:VATSALA
Middle Name:
Last Name:BHARDWAJ
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2929
Mailing Address - Country:US
Mailing Address - Phone:212-698-0338
Mailing Address - Fax:212-698-9565
Practice Address - Street 1:521 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2929
Practice Address - Country:US
Practice Address - Phone:212-698-0338
Practice Address - Fax:212-698-9565
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMD208394-1207ZH0000X
UTMD96-237163-1205207ZH0000X
PAMD068319-L207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology