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NPI Code Detail

MEDICARE: MR. ANINDA K CHAKRABORTY OTR/L

MEDICARE:  MR. ANINDA K CHAKRABORTY  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist003389MO

General Provider Information

NPI Number : 1033403977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANINDA K CHAKRABORTY OTR/L
Provider Business Mailing Address
First Line : 3422 W ERIE ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-8254
Country : US
Telephone Number : 417-766-0839
Fax Number :
Provider Business Practice Location Address
First Line : 3422 W ERIE ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-8254
Country : US
Telephone Number : 417-766-0839
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2011
Last Update Date : 06/08/2011

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Directions to “ MR. ANINDA K CHAKRABORTY OTR/L” Practice Location

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