Healthcare Provider Details
I. General information
NPI: 1225960628
Provider Name (Legal Business Name): ANANYA CHAKRABORTY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US
IV. Provider business mailing address
626 TODD RD
MARTINEZ GA
30907-9640
US
V. Phone/Fax
- Phone: 703-776-4001
- Fax:
- Phone: 706-306-8896
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 0116042324 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: