Healthcare Provider Details

I. General information

NPI: 1912984287
Provider Name (Legal Business Name): SANGEETA BHATTACHARYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 PHILADELPHIA PIKE
CLAYMONT DE
19703-2430
US

IV. Provider business mailing address

2401 PHILADELPHIA PIKE
CLAYMONT DE
19703-2430
US

V. Phone/Fax

Practice location:
  • Phone: 302-428-4110
  • Fax: 302-798-6672
Mailing address:
  • Phone: 302-428-4110
  • Fax: 302-798-6672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0006976
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0006976
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: