Basic Information
| Provider Information | |||||||||
| NPI: | 1508066085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHAT | ||||||||
| FirstName: | SHAZIA | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HYGEIA DR | ||||||||
| Address2: | SUITE 2300, PHYSICIAN CONTRACTING | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155904670 | ||||||||
| FaxNumber: | 2155902204 | ||||||||
| Practice Location | |||||||||
| Address1: | 4745 OGLETOWN STANTON ROAD | ||||||||
| Address2: | MAP 1, SUITE 217 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027332410 | ||||||||
| FaxNumber: | 3027332602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2007 | ||||||||
| LastUpdateDate: | 09/03/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MT188043 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | C1-0010449 | DE | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | 208000000X | C1-0010449 | DE | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.