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NPI Code Detail

MEDICARE: DIYA CHAKRABORTY MD

MEDICARE: DIYA CHAKRABORTY 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
12084N0402XNeurology with Special Qualifications in Child Neurology Physician47311OK
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1801359971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIYA CHAKRABORTY MD
Provider Business Mailing Address
First Line : 920 STANTON L YOUNG BLVD STE 2040
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-5036
Country : US
Telephone Number : 405-271-4113
Fax Number :
Provider Business Practice Location Address
First Line : 1025 STRAKA TER
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-2544
Country : US
Telephone Number : 405-632-6688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2019
Last Update Date : 06/03/2026

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Directions to “ DIYA CHAKRABORTY MD” Practice Location

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