Healthcare Provider Details

I. General information

NPI: 1790867059
Provider Name (Legal Business Name): ARSHAD ALI CHATHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 E 138TH ST
BRONX NY
10454-3307
US

IV. Provider business mailing address

342 MERCER ST
JERSEY CITY NJ
07302-3118
US

V. Phone/Fax

Practice location:
  • Phone: 718-585-0008
  • Fax:
Mailing address:
  • Phone: 201-432-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number183114
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: