Healthcare Provider Details

I. General information

NPI: 1609874833
Provider Name (Legal Business Name): ARUN KUMAR BHATTACHARYYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51-55 RT. 9W HELEN HAYES HOSPITAL
WEST HAVERSTRAW NY
10993-1195
US

IV. Provider business mailing address

49 LONG MEADOW DR
NEW CITY NY
10956-6223
US

V. Phone/Fax

Practice location:
  • Phone: 845-786-4101
  • Fax: 845-786-4890
Mailing address:
  • Phone: 845-638-1855
  • Fax: 845-638-1855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number119036
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: