MEDICARE: ADITI BHATTACHARYA LMSW

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	1041C0700X	Clinical Social Worker	085628	NY

General Provider Information

NPI Number	:	1154666410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADITI BHATTACHARYA LMSW

Provider Business Mailing Address
First Line	:	26 WELDON ST
Second Line	:	APT. 1
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5779
Country	:	US
Telephone Number	:	646-300-4632
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 WELDON ST
Second Line	:	APT. 1
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5779
Country	:	US
Telephone Number	:	646-300-4632
Fax Number	:

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

Provider Enumeration Date	:	11/27/2012
Last Update Date	:	04/09/2017

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