Individual
DR. SUSHEEL BATHLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
364 EDISON ST, STATEN ISLAND, NY 10306-3041
(718) 524-4112
(718) 524-4189
Mailing address
172 DEER RUN, WATCHUNG, NJ 07069-6222
(718) 524-4112
(718) 524-4189
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
N005417
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01918189
—
NY
Enumeration date
05/30/2005
Last updated
10/02/2013
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