MEDICARE: DR. CHAITANYA SRAVANTHI CHANDRAVANKA 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	273632	NY
2	208M00000X	Hospitalist Physician	273632	NY

General Provider Information

NPI Number	:	1598942666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAITANYA SRAVANTHI CHANDRAVANKA M.D

Provider Business Mailing Address
First Line	:	6011 SINGLETREE LN DEPT OF
Second Line	:
City	:	JAMESVILLE
State	:	NY
Zip	:	13078-9589
Country	:	US
Telephone Number	:	313-415-8537
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 E ADAMS ST DEPT OF
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-1834
Country	:	US
Telephone Number	:	315-464-5774
Fax Number	:

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

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	01/15/2024

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