Provider Demographics
NPI:1811985765
Name:BHATT, ANJALI G (MD)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:G
Last Name:BHATT
Suffix:
Gender:F
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:PO BOX 750
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501-0750
Mailing Address - Country:US
Mailing Address - Phone:510-346-7797
Mailing Address - Fax:510-342-9802
Practice Address - Street 1:503 N 21ST ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2204
Practice Address - Country:US
Practice Address - Phone:717-763-2900
Practice Address - Fax:717-293-3328
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034601L207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0969943Medicaid
PA220029476OtherRR MEDICARE
PA220029476OtherRR MEDICARE
PA137218Medicare ID - Type Unspecified
PA0969943Medicaid