Healthcare Provider Details

I. General information

NPI: 1093447054
Provider Name (Legal Business Name): SALMAN BHATTI OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4595 CANTRELL RD
FLOWERY BRANCH GA
30542-3304
US

IV. Provider business mailing address

250 SKILLMAN ST STE 202
BROOKLYN NY
11205-1218
US

V. Phone/Fax

Practice location:
  • Phone: 718-964-6161
  • Fax:
Mailing address:
  • Phone: 718-964-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPT003419
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003419
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: