Provider Demographics
NPI:1356437560
Name:BHATTY, SAMINA B (MD)
Entity type:Individual
Prefix:DR
First Name:SAMINA
Middle Name:B
Last Name:BHATTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-0272
Mailing Address - Country:US
Mailing Address - Phone:631-224-1878
Mailing Address - Fax:631-224-7963
Practice Address - Street 1:50 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1348
Practice Address - Country:US
Practice Address - Phone:631-862-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1919992080N0001X
NY191999-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSB644X91OtherEMPIRE BC/BS
NY131828429OtherHIP HEALTHCARE PARTNERS
NY1356437560OtherOTHER
NY2120398OtherVYTRA HEALTH PLANS
NY5C4700OtherHEALTHNET
NYON25343OtherMDNY
NY0112362OtherGHI
NYP3555372OtherOXFORD
NY01423261Medicaid
NY3451146OtherAETNA HEALTH PLANS
NY191999OtherHIP FAMILY HEALTH PLUS
NY9062538OtherCIGNA HEALTHCARE