Healthcare Provider Details

I. General information

NPI: 1578764783
Provider Name (Legal Business Name): RAJESH CHATKARA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3538 HABERSHAM AT NORTHLAKE
TUCKER GA
30084-4009
US

IV. Provider business mailing address

4090 PINESET DR
ALPHARETTA GA
30022-4969
US

V. Phone/Fax

Practice location:
  • Phone: 770-939-8720
  • Fax: 770-938-7288
Mailing address:
  • Phone: 770-569-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT003550
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: