Basic Information
| Provider Information | |||||||||
| NPI: | 1356437560 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHATTY | ||||||||
| FirstName: | SAMINA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 272 | ||||||||
| Address2: | |||||||||
| City: | EAST ISLIP | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117300272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312241878 | ||||||||
| FaxNumber: | 6312247963 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 ROUTE 25A | ||||||||
| Address2: | |||||||||
| City: | SMITHTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117871348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318623250 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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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 | 174400000X | 191999-1 | NY | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 3451146 | 01 | NY | AETNA HEALTH PLANS | OTHER | SB644X91 | 01 | NY | EMPIRE BC/BS | OTHER | 01423261 | 05 | NY | MEDICAID | 191999 | 01 | NY | HIP FAMILY HEALTH PLUS | OTHER | ON25343 | 01 | NY | MDNY | OTHER | 0112362 | 01 | NY | GHI | OTHER | 5C4700 | 01 | NY | HEALTHNET | OTHER | 2120398 | 01 | NY | VYTRA HEALTH PLANS | OTHER | 9062538 | 01 | NY | CIGNA HEALTHCARE | OTHER | P3555372 | 01 | NY | OXFORD | OTHER |