Healthcare Provider Details

I. General information

NPI: 1124721063
Provider Name (Legal Business Name): ANTARA CHAKRABORTY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 DURHAM RD
DOVER NH
03820-4791
US

IV. Provider business mailing address

14B TSIENNETO RD
DERRY NH
03038-1560
US

V. Phone/Fax

Practice location:
  • Phone: 603-537-1300
  • Fax:
Mailing address:
  • Phone: 603-537-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38462
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: