Provider Demographics
NPI:1306884879
Name:BHASKAR, VATSALA R (MD, FAAP)
Entity type:Individual
Prefix:DR
First Name:VATSALA
Middle Name:R
Last Name:BHASKAR
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Gender:F
Credentials:MD, FAAP
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Mailing Address - Street 1:57 SCHANCK RD
Mailing Address - Street 2:SUITE C14 C15
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3072
Mailing Address - Country:US
Mailing Address - Phone:732-431-9202
Mailing Address - Fax:732-431-9205
Practice Address - Street 1:57 SCHANCK RD
Practice Address - Street 2:SUITE C14 C15
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3072
Practice Address - Country:US
Practice Address - Phone:732-431-9202
Practice Address - Fax:732-431-9205
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2019-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA0698682080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8104204Medicaid