Provider Demographics
NPI:1992192991
Name:PLATTSBURGH INTERNAL MEDICINE
Entity Type:Organization
Organization Name:PLATTSBURGH INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JATINDER
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:BHASIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-561-4170
Mailing Address - Street 1:72 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2925
Mailing Address - Country:US
Mailing Address - Phone:518-561-4170
Mailing Address - Fax:518-561-4181
Practice Address - Street 1:72 MARGARET ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2925
Practice Address - Country:US
Practice Address - Phone:518-561-4170
Practice Address - Fax:518-561-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH43960Medicare UPIN