Healthcare Provider Details

I. General information

NPI: 1417161704
Provider Name (Legal Business Name): AJAY BHATNAGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-8024
  • Fax: 717-531-0446
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD2023-1495
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number36390
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number425112
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number327337
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number110561
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number23276
License Number StateNV
# 7
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberCDR.0002379
License Number StateCO
# 8
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD425112
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier327337
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerMEDICAL LICENSE
# 2
Identifier7055777
Identifier TypeOTHER
Identifier StateAZ
Identifier IssuerCIGNA
# 3
Identifier264354
Identifier TypeMEDICAID
Identifier StateAZ
Identifier Issuer
# 4
Identifier7802920
Identifier TypeOTHER
Identifier StateAZ
Identifier IssuerAETNA
# 5
IdentifierP01505470
Identifier TypeOTHER
Identifier StateFL
Identifier IssuerRAILROAD MEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: