MEDICARE: CHHAYA CHAKRABARTI MD

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	2080P0205X	Pediatric Endocrinology Physician	119053	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

General Provider Information

NPI Number	:	1679589774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHHAYA CHAKRABARTI MD

Provider Business Mailing Address
First Line	:	8918 LEFFERTS BLVD
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-3218
Country	:	US
Telephone Number	:	718-846-2222
Fax Number	:	718-846-2866

Provider Business Practice Location Address
First Line	:	8918 LEFFERTS BLVD
Second Line	:
City	:	RICHMOND HILL
State	:	NY
Zip	:	11418-3218
Country	:	US
Telephone Number	:	718-846-2222
Fax Number	:	718-846-2866

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	04/15/2012

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