Healthcare Provider Details

I. General information

NPI: 1225249113
Provider Name (Legal Business Name): SOKUN KY BHATTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 PRIDES XING STE 200
NEWARK DE
19713-6109
US

IV. Provider business mailing address

700 PRIDES XING STE 200
NEWARK DE
19713-6109
US

V. Phone/Fax

Practice location:
  • Phone: 302-998-0300
  • Fax:
Mailing address:
  • Phone: 302-998-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number2010-02132
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57009457
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberC1-0012638
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: