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General NPI Number Information
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NPI Number | 1104872530
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Entity Type | Individual
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Provider Name | KIRAN K BHAT M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 55 GREENE AVE
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City | BROOKLYN
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State | NY
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Zip | 11238-1026
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Country | US
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Telephone | 917-400-9426
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Fax | 718-250-6489
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Provider Business Mailing Address
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Address Line | 297 ADELPHI ST
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City | BROOKLYN
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State | NY
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Zip | 11205-4602
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Country | US
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Telephone | 917-385-3960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 179103
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License Number State | NY
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