Basic Information
| Provider Information | |||||||||
| NPI: | 1336411990 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHAT | ||||||||
| FirstName: | PRAVIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 COURT ST | ||||||||
| Address2: | 7KN | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112015663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9174464763 | ||||||||
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| Practice Location | |||||||||
| Address1: | 374 STOCKHOLM ST | ||||||||
| Address2: | 406 NORTH | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112374006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189637585 | ||||||||
| FaxNumber: | 7184864270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2012 | ||||||||
| LastUpdateDate: | 01/29/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 07228497 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.