Provider Demographics
NPI:1356417208
Name:BHATTY, NEENA M (DDS)
Entity type:Individual
Prefix:DR
First Name:NEENA
Middle Name:M
Last Name:BHATTY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NEENA
Other - Middle Name:VIPINCHANDRA
Other - Last Name:GUNDERIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:165 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4702
Mailing Address - Country:US
Mailing Address - Phone:914-941-1263
Mailing Address - Fax:914-941-0993
Practice Address - Street 1:OPEN DOOR MEDICAL CENTER, 165 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562
Practice Address - Country:US
Practice Address - Phone:914-941-1263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00548605Medicaid