Provider Demographics
NPI:1174986228
Name:BHAGWAT, NIYATI AJIT
Entity type:Individual
Prefix:
First Name:NIYATI
Middle Name:AJIT
Last Name:BHAGWAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NIYATI
Other - Middle Name:AJIT
Other - Last Name:BHAGWAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:NYU WINTHROP HOSPITAL
Mailing Address - Street 2:259 1ST STREET
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-663-0333
Mailing Address - Fax:
Practice Address - Street 1:NYU WINTHROP HOSPITAL
Practice Address - Street 2:259 1ST STREET
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-663-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300406208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist