Basic Information
| Provider Information | |||||||||
| NPI: | 1043837743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHATIA | ||||||||
| FirstName: | KULSAJAN | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 CLARKSON AVE. SUNY DOWNSTATE MEDICAL CENTER | ||||||||
| Address2: | 450 CLARKSON AVE PEDIATRICS DEPARTMENT- SUITE D | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9172149882 | ||||||||
| FaxNumber: | 7182701985 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 CLARKSON AVE 1203-2098 SUNY DOWNSTATE | ||||||||
| Address2: | SUITE -D DEPARTMENT OF PEDIATRICS | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112032098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182702078 | ||||||||
| FaxNumber: | 7182701985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2020 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 01/17/2022 | ||||||||
| NPIReactivationDate: | 02/11/2022 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.