Basic Information
Provider Information
NPI: 1336515147
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BHASIN
FirstName: AARTI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1129 NORTHERN BLVD STE 101
Address2:  
City: MANHASSET
State: NY
PostalCode: 110303022
CountryCode: US
TelephoneNumber: 5163655570
FaxNumber:  
Practice Location
Address1: 1129 NORTHERN BLVD STE 101
Address2:  
City: MANHASSET
State: NY
PostalCode: 110303022
CountryCode: US
TelephoneNumber: 5163655570
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/16/2015
LastUpdateDate: 09/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X304606NYY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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