Provider Demographics
NPI:1942244405
Name:BHATIA, SANJAY P (MD)
Entity Type:Individual
Prefix:
First Name:SANJAY
Middle Name:P
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 WOODBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1540
Mailing Address - Country:US
Mailing Address - Phone:215-943-2000
Mailing Address - Fax:215-943-4439
Practice Address - Street 1:1411 WOODBOURNE RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1540
Practice Address - Country:US
Practice Address - Phone:215-943-2000
Practice Address - Fax:215-943-4439
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08035100207R00000X
PAMD431016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTP00426189OtherRAIL ROAD MEDICARE
MOP00427721OtherRAIL ROAD MEDICARE
PAP00765921OtherRR MEDICARE
PAP00795382OtherRR MEDICARE- LOWER BUCKS
PA30060275OtherKEYSTONE MERCY-LOWER BUCKS GROUP
NJP00399305OtherRAIL ROAD MEDICARE
SC302336Medicaid
NJ0101451Medicaid
VT1014200Medicaid
PA101934640 0002Medicaid
PA30061936OtherKEYSTONE MERCY
MO109994TGVMedicare PIN
VT000255001Medicare PIN
VTP00426189OtherRAIL ROAD MEDICARE
PA30061936OtherKEYSTONE MERCY
NJ100159TN1Medicare ID - Type Unspecified
SCAA25668831Medicare PIN
PA101934640 0002Medicaid
VT1014200Medicaid