MEDICARE: DR. MANSI BHATT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS1201X	Sleep Medicine (Family Medicine) Physician	25MA13058200	NJ
2	207Q00000X	Family Medicine Physician	25MA13058200	NJ

General Provider Information

NPI Number	:	1003565607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANSI BHATT MD

Provider Business Mailing Address
First Line	:	PO BOX 416457
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6457
Country	:	US
Telephone Number	:	844-362-1735
Fax Number	:	973-290-7495

Provider Business Practice Location Address
First Line	:	741 NORTHFIELD AVE STE 201
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-1104
Country	:	US
Telephone Number	:	973-379-5181
Fax Number	:	973-379-6181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2022
Last Update Date	:	06/18/2026

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