MEDICARE: NEHA BATHEJA PA

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
1	363AM0700X	Medical Physician Assistant	001874	CT

General Provider Information

NPI Number	:	1346397676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEHA BATHEJA PA

Provider Business Mailing Address
First Line	:	24 EAST WINTONBURY AVE
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3119
Country	:	US
Telephone Number	:	516-343-3866
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 EAST WINTONBURY AVE
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3119
Country	:	US
Telephone Number	:	516-343-3866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	11/23/2011

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