Healthcare Provider Details
I. General information
NPI: 1851744155
Provider Name (Legal Business Name): AMIT MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2016
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
61 GRASSLANDS RD
VALHALLA NY
10595-1543
US
IV. Provider business mailing address
140 BRAMBLEBROOK RD
ARDSLEY NY
10502-2207
US
V. Phone/Fax
- Phone: 914-681-8666
- Fax:
- Phone:
- Fax: 914-202-0292
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 253693 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AMIT
CHHABRA
Title or Position: SELF
Credential: MD
Phone: 718-424-4548