Provider Demographics
NPI:1871180950
Name:BHATTA, DIPTINA
Entity Type:Individual
Prefix:
First Name:DIPTINA
Middle Name:
Last Name:BHATTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 PEBBLE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2650
Mailing Address - Country:US
Mailing Address - Phone:571-212-3372
Mailing Address - Fax:
Practice Address - Street 1:9911 BELWARE CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3984
Practice Address - Country:US
Practice Address - Phone:240-672-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR229783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse