Healthcare Provider Details

I. General information

NPI: 1164625745
Provider Name (Legal Business Name): MANJULA CHATTERJEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2007
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E WOODSIDE AVE
PATCHOGUE NY
11772-1421
US

IV. Provider business mailing address

121 DEKALB AVE
BROOKLYN NY
11201-5425
US

V. Phone/Fax

Practice location:
  • Phone: 646-283-7151
  • Fax: 631-758-6568
Mailing address:
  • Phone: 718-250-8000
  • Fax: 718-250-6856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number234874
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: