MEDICARE: KOMAL BHATIA

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	104100000X	Social Worker	115970-01	NY
2	1041C0700X	Clinical Social Worker	103243	NY

General Provider Information

NPI Number	:	1871236067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOMAL BHATIA

Provider Business Mailing Address
First Line	:	6214 RIVERDALE AVE # 1A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-1032
Country	:	US
Telephone Number	:	718-701-4807
Fax Number	:	718-701-4806

Provider Business Practice Location Address
First Line	:	6214 RIVERDALE AVE # 1A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-1032
Country	:	US
Telephone Number	:	718-701-4807
Fax Number	:	718-701-4806

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

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	06/07/2026

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Directions to “ KOMAL BHATIA ” Practice Location

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