Provider Demographics
NPI:1720287022
Name:PRAFUL U. BHATT, MD
Entity Type:Organization
Organization Name:PRAFUL U. BHATT, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRAFUL
Authorized Official - Middle Name:U
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-748-4565
Mailing Address - Street 1:72 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-2023
Mailing Address - Country:US
Mailing Address - Phone:570-748-4565
Mailing Address - Fax:570-748-3034
Practice Address - Street 1:72 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2023
Practice Address - Country:US
Practice Address - Phone:570-748-4565
Practice Address - Fax:570-748-3034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025716E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty