Provider Demographics
NPI:1891022091
Name:PRADIP BHATTACHARJEE, M.D. PC
Entity Type:Organization
Organization Name:PRADIP BHATTACHARJEE, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOPATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRADIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTACHARJE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-719-3168
Mailing Address - Street 1:65 RANCHO MIRAGE CT
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2555
Mailing Address - Country:US
Mailing Address - Phone:248-719-3168
Mailing Address - Fax:
Practice Address - Street 1:65 RANCHO MIRAGE CT
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2555
Practice Address - Country:US
Practice Address - Phone:248-719-3168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08646700207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty