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General NPI Number Information
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NPI Number | 1689102998
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Entity Type | Individual
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Provider Name | ROBIN S CHIRACKAL MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 330 W 58TH ST STE 509
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City | NEW YORK
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State | NY
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Zip | 10019-1819
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Country | US
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Telephone | 212-994-5100
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Fax | 212-994-5101
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Provider Business Mailing Address
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Address Line | 565 NEW BRUNSWICK AVE STE 101
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City | FORDS
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State | NJ
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Zip | 08863-2162
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Country | US
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Telephone | 212-994-5100
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10061266
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 318362
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 318362
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 8218
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License Number State | NE
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