Provider Demographics
NPI:1386783686
Name:BAKHATY, ABDEL RAHMAN SAYED (MD)
Entity type:Individual
Prefix:MR
First Name:ABDEL RAHMAN
Middle Name:SAYED
Last Name:BAKHATY
Suffix:
Gender:M
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 3485
Mailing Address - Street 2:
Mailing Address - City:SECAUNCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094
Mailing Address - Country:US
Mailing Address - Phone:201-217-6822
Mailing Address - Fax:201-217-6899
Practice Address - Street 1:3200 KENNEDY BOULEVARD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3416
Practice Address - Country:US
Practice Address - Phone:201-217-6822
Practice Address - Fax:201-217-6899
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 042237207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJJ018597OtherTRICARE
NJP2751747OtherOXFORD
NJ0724807Medicaid
NJP2751747OtherOXFORD