Provider Demographics
NPI:1053581793
Name:BHATTI, JAVED AHMAD
Entity type:Individual
Prefix:
First Name:JAVED
Middle Name:AHMAD
Last Name:BHATTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 CHAUCER DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3825
Mailing Address - Country:US
Mailing Address - Phone:717-545-8410
Mailing Address - Fax:
Practice Address - Street 1:1821 FULTON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-1522
Practice Address - Country:US
Practice Address - Phone:717-236-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034055L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP034055LOtherPHARMACY LICENSE