Provider Demographics
NPI:1922267103
Name:BAMJI, NATASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:BAMJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-367-0000
Mailing Address - Fax:914-367-0001
Practice Address - Street 1:503 GRASSLANDS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1503
Practice Address - Country:US
Practice Address - Phone:914-367-0000
Practice Address - Fax:914-367-0001
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY248435208000000X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03458853Medicaid
NYA400074474Medicare PIN
NYA400074475Medicare PIN