Provider Demographics
NPI:1033435946
Name:CHAKRABARTI, DILIP KUMAR (R PH)
Entity Type:Individual
Prefix:MR
First Name:DILIP
Middle Name:KUMAR
Last Name:CHAKRABARTI
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418A SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4004
Mailing Address - Country:US
Mailing Address - Phone:845-323-6089
Mailing Address - Fax:
Practice Address - Street 1:2418 2ND ST UNIT A
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4004
Practice Address - Country:US
Practice Address - Phone:845-323-6089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035240OtherNEW YORK STATE PHARMACIST'S REGISTRATION NUMBER