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General NPI Number Information
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NPI Number | 1851393870
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Entity Type | Individual
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Provider Name | BHASKAR BHATTACHARYYA DPM
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 1404 PORTLAND AVENUE
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City | ROCHESTER
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State | NY
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Zip | 14621-3016
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Country | US
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Telephone | 585-266-1940
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Fax | 585-266-2223
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Provider Business Mailing Address
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Address Line | 908 NIAGARA FALLS BLVD STE 208
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City | N TONAWANDA
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State | NY
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Zip | 14120
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Country | US
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Telephone | 716-692-2160
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Fax | 716-213-0348
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N005831-3
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 005831
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License Number State | NY
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