Healthcare Provider Details

I. General information

NPI: 1942426853
Provider Name (Legal Business Name): YESHWANT RAMCHANDRA CHITALKAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 VARICK ST 9TH FLOOR
NEW YORK NY
10014-4810
US

IV. Provider business mailing address

91 PIONEER ST
BROOKLYN NY
11231-1610
US

V. Phone/Fax

Practice location:
  • Phone: 212-620-0340
  • Fax: 212-620-5842
Mailing address:
  • Phone: 646-298-9630
  • Fax: 212-620-5842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number240655
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: