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General NPI Number Information
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NPI Number | 1437640950
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Entity Type | Individual
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Provider Name | EESHA CHAKRAVARTTY MD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 18133 VENTURA BLVD STE 405
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City | TARZANA
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State | CA
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Zip | 91356-3726
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Country | US
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Telephone | 424-315-0285
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Fax |
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Provider Business Mailing Address
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Address Line | 585 SCHENECTADY AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-1851
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Country | US
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Telephone | 718-363-6771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 312067
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A193698
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License Number State | CA
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