Provider Demographics
NPI:1952381287
Name:BHATT, PRANAY J (MD)
Entity Type:Individual
Prefix:DR
First Name:PRANAY
Middle Name:J
Last Name:BHATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:350 BLOOMFIELD AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4897
Mailing Address - Country:US
Mailing Address - Phone:973-748-3990
Mailing Address - Fax:973-748-6985
Practice Address - Street 1:350 BLOOMFIELD AVE STE 1
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4852
Practice Address - Country:US
Practice Address - Phone:973-748-9330
Practice Address - Fax:201-666-3205
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07717300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0042081Medicaid
NJ0042081Medicaid
NJI21297Medicare UPIN