Provider Demographics
NPI:1063193407
Name:BHATTARAI, YASHASWEE
Entity type:Individual
Prefix:
First Name:YASHASWEE
Middle Name:
Last Name:BHATTARAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 TALL TREES DR
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2255
Mailing Address - Country:US
Mailing Address - Phone:347-605-0146
Mailing Address - Fax:
Practice Address - Street 1:703 RUTTER AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-4801
Practice Address - Country:US
Practice Address - Phone:570-288-7405
Practice Address - Fax:570-288-7406
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG004047152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist