Provider Demographics
NPI:1740500479
Name:BHATTACHARYA, BISHWAJIT (MD)
Entity type:Individual
Prefix:DR
First Name:BISHWAJIT
Middle Name:
Last Name:BHATTACHARYA
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 1:44 ORANGE ST
Mailing Address - Street 2:APT # 301
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3130
Mailing Address - Country:US
Mailing Address - Phone:914-374-1410
Mailing Address - Fax:
Practice Address - Street 1:333 CEDAR ST.
Practice Address - Street 2:YALE MEDICAL SCHOOL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-432-4771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0494862086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery