MEDICARE: VIMAL BHATT

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	2471S1302X	Sonography Radiologic Technologist
2	2471V0105X	Vascular Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1184092892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIMAL BHATT

Provider Business Mailing Address
First Line	:	1243 60TH ST # 1RR
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4930
Country	:	US
Telephone Number	:	347-633-3505
Fax Number	:	718-618-7255

Provider Business Practice Location Address
First Line	:	1243 60TH ST # 1RR
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4930
Country	:	US
Telephone Number	:	347-633-3505
Fax Number	:	718-618-7255

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

Provider Enumeration Date	:	09/11/2015
Last Update Date	:	09/11/2015

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Directions to “ VIMAL BHATT ” Practice Location

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