Provider Demographics
NPI:1164886396
Name:SAFI, CHETAN Y (MD)
Entity Type:Individual
Prefix:
First Name:CHETAN
Middle Name:Y
Last Name:SAFI
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 1:985 BERKSHIRE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1268
Mailing Address - Country:US
Mailing Address - Phone:610-374-5599
Mailing Address - Fax:610-375-1262
Practice Address - Street 1:985 BERKSHIRE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1268
Practice Address - Country:US
Practice Address - Phone:610-374-5599
Practice Address - Fax:610-375-1262
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477869207Y00000X
390200000X
NY308481207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program