Healthcare Provider Details

I. General information

NPI: 1215978267
Provider Name (Legal Business Name): MATTOO & BHAT MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 SENECA AVE
RIDGEWOOD NY
11385-1340
US

IV. Provider business mailing address

385 SENECA AVE
RIDGEWOOD NY
11385-1340
US

V. Phone/Fax

Practice location:
  • Phone: 718-899-0060
  • Fax: 718-559-6758
Mailing address:
  • Phone: 718-899-0060
  • Fax: 718-559-6758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JODUMUTT G BHAT
Title or Position: PRESIDENT
Credential: MD
Phone: 718-899-0060