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NPI Code Detail

MEDICARE: VASUNDHARA BHATT

MEDICARE: VASUNDHARA BHATT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry060027NY

General Provider Information

NPI Number : 1205318516
Entity Type Code : Individual
Provider Name (Legal Business Name) : VASUNDHARA BHATT
Provider Business Mailing Address
First Line : 3304 93RD ST APT 2L
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-1901
Country : US
Telephone Number : 315-794-4407
Fax Number :
Provider Business Practice Location Address
First Line : 3809 JUNCTION BLVD
Second Line :
City : CORONA
State : NY
Zip : 11368-2153
Country : US
Telephone Number : 315-794-4407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2018
Last Update Date : 09/04/2018

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Directions to “ VASUNDHARA BHATT ” Practice Location

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