MEDICARE: MR. ANUKUL CHANDRA NANDI M.D.

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
1	207R00000X	Internal Medicine Physician	111958	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	111958	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1164524740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANUKUL CHANDRA NANDI M.D.

Provider Business Mailing Address
First Line	:	53 SYRACUSE ST
Second Line	:
City	:	WILLISTON PARK
State	:	NY
Zip	:	11596-1335
Country	:	US
Telephone Number	:	516-873-6355
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3519
Country	:	US
Telephone Number	:	718-449-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	04/25/2011

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