Healthcare Provider Details

I. General information

NPI: 1083785885
Provider Name (Legal Business Name): MUHAMMADA RIAZ BHATTI MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 HOOPER ST
BROOKLYN NY
11211-6450
US

IV. Provider business mailing address

319 HOOPER ST
BROOKLYN NY
11211-6450
US

V. Phone/Fax

Practice location:
  • Phone: 718-486-7116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number195628
License Number StateNY

VIII. Authorized Official

Name: MUHAMMAD RIAZ BHATTI
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 718-486-7116