Provider Demographics
NPI:1003942871
Name:CHITRAKAR, TARA DEVI (MD)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:DEVI
Last Name:CHITRAKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 RED MILLS RD
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-3220
Mailing Address - Country:US
Mailing Address - Phone:845-744-9105
Mailing Address - Fax:845-744-9107
Practice Address - Street 1:800 RED MILLS RD
Practice Address - Street 2:
Practice Address - City:WALLKILL
Practice Address - State:NY
Practice Address - Zip Code:12589-3220
Practice Address - Country:US
Practice Address - Phone:458-744-9105
Practice Address - Fax:845-744-9107
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA 166972-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine