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NPI Code Detail

MEDICARE: RAJESH G. BHAGAT M.D.

MEDICARE:   RAJESH G. BHAGAT  M.D.
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
1207K00000XAllergy & Immunology PhysicianMD-030862-EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1104119OTHERPAHIGHMARK BLUE SHIELD
2104119OTHERPABLUE SHIELD
3440783OTHERPAFIRST PRIORITY HEALTH

General Provider Information

NPI Number : 1558363358
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAJESH G. BHAGAT M.D.
Provider Business Mailing Address
First Line : 292 EAST BROWN STREET
Second Line :
City : EAST STROUDSBURG
State : PA
Zip : 18301-3006
Country : US
Telephone Number : 570-424-1790
Fax Number : 570-424-1791
Provider Business Practice Location Address
First Line : 292 EAST BROWN STREET
Second Line :
City : EAST STROUDSBURG
State : PA
Zip : 18301-3006
Country : US
Telephone Number : 570-424-1790
Fax Number : 570-424-1791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 06/14/2010

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