Provider Demographics
NPI:1114999083
Name:CHATTA, GURKAMAL SINGH (MD)
Entity Type:Individual
Prefix:
First Name:GURKAMAL
Middle Name:SINGH
Last Name:CHATTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ELM AND CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:716-845-2300
Mailing Address - Fax:716-845-3519
Practice Address - Street 1:ELM AND CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-3519
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417845174400000X
WAMD00025531207RH0003X
NY284329207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No174400000XOther Service ProvidersSpecialist
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP01023152OtherRAILROAD MEDICARE
PA001748651Medicaid
WA1114999083Medicaid
PAF15994Medicare UPIN
WAP01023152OtherRAILROAD MEDICARE
WA1114999083Medicaid
WA8910721Medicare PIN
WA1114999083Medicaid