Basic Information
| Provider Information | |||||||||
| NPI: | 1881651727 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHATIA | ||||||||
| FirstName: | JYOTI | ||||||||
| MiddleName: | KAMLESH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 LOCKWOOD DR | ||||||||
| Address2: | |||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085406122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099477460 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | TWO CAPITAL WAY | ||||||||
| Address2: | SUITE 487 | ||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098181900 | ||||||||
| FaxNumber: | 6098181908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 04/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MA77892 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | P3487858 | 01 | OXFORD | OTHER | 0089052 | 05 | NJ | MEDICAID | 2396161000 | 01 | AMERIHEALTH | OTHER | 7251581 | 01 | AETNA | OTHER |