Individual
MR. BASSAM FAIZ BITTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
564 W. BROAD ST., HAZLETON, PA 18201
(570) 501-6400
(570) 453-2353
Mailing address
564 W. BROAD ST., HAZLETON, PA 18201
(570) 501-6400
(570) 453-2353
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD-056973
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016887960001
—
PA
01
—
001961
FIRST PRIORITY HEALTH ID#
PA
01
—
BI813177
BLUE CROSS BLUE SHIELD
PA
Enumeration date
06/13/2005
Last updated
06/20/2024
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