Healthcare Provider Details

I. General information

NPI: 1053707927
Provider Name (Legal Business Name): SAKIL CHUNDYDYAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 CAMBRIDGE ST ROOM 206
CAMBRIDGE MA
02139-1047
US

IV. Provider business mailing address

182 ALEWIFE BROOK PKWY # 1062
CAMBRIDGE MA
02138-1102
US

V. Phone/Fax

Practice location:
  • Phone: 617-575-5447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number274144
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: