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General NPI Number Information
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NPI Number | 1477433209
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Entity Type | Organization
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Legal Business Name | BINU CHACKO MD PC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 366 N BROADWAY SUITE PHE1
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City | JERICHO
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State | NY
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Zip | 11753-2020
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Country | US
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Telephone | 424-242-2568
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Fax | 516-897-3099
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Provider Business Mailing Address
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Address Line | 366 N BROADWAY SUITE PHE1
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City | JERICHO
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State | NY
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Zip | 11753-2020
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Country | US
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Telephone | 424-242-2568
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Fax | 516-897-3099
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Authorized Official
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Title or Position | PHYSICIAN
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Name | BINU CHACKO
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Credential | MD
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Telephone | 424-242-2568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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