Healthcare Provider Details

I. General information

NPI: 1740556349
Provider Name (Legal Business Name): RAJ SLEEP & PULMONARY MEDICINE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7554 METROPOLITAN AVE
MIDDLE VILLAGE NY
11379-2639
US

IV. Provider business mailing address

9 CARRI FARM CT
SCOTCH PLAINS NJ
07076-2555
US

V. Phone/Fax

Practice location:
  • Phone: 718-894-4200
  • Fax: 718-894-3900
Mailing address:
  • Phone: 908-510-4080
  • Fax: 908-322-1897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. UTPAL K BHATT
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 908-510-4080