Provider Demographics
NPI:1770512485
Name:BHATNAGAR, NITIN (DO)
Entity Type:Individual
Prefix:DR
First Name:NITIN
Middle Name:
Last Name:BHATNAGAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:230 MAPLE STREET, STE 301
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01041-0391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2511
Practice Address - Country:US
Practice Address - Phone:413-774-2222
Practice Address - Fax:413-774-2225
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ27143OtherBLUE CROSS
MA2030691Medicaid
I04011Medicare UPIN
MAJ27143OtherBLUE CROSS
A36618Medicare PIN