Provider Demographics
NPI:1912952441
Name:KHAMBATTA, HOSHANG J (MD)
Entity type:Individual
Prefix:
First Name:HOSHANG
Middle Name:J
Last Name:KHAMBATTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BEDFORD ANESTHESIA, PLLC
Mailing Address - Street 2:110 SOUTH BEDFORD ROAD
Mailing Address - City:MT. KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-244-6789
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:BEDFORD ANESTHESIA, PLLC
Practice Address - Street 2:34 SOUTH BEDFORD ROAD
Practice Address - City:MT. KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-244-6789
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY107289207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17273Medicare UPIN
NY9L1811Medicare ID - Type Unspecified