Provider Demographics
NPI:1427248558
Name:BHATIA, LINI S (MD)
Entity type:Individual
Prefix:
First Name:LINI
Middle Name:S
Last Name:BHATIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 GROSSMAN DR
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4997
Mailing Address - Country:US
Mailing Address - Phone:781-849-2400
Mailing Address - Fax:781-849-2593
Practice Address - Street 1:111 GROSSMAN DR
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4997
Practice Address - Country:US
Practice Address - Phone:781-849-2400
Practice Address - Fax:781-849-2593
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA232151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2149672Medicaid
MA000488601Medicare PIN