Provider Demographics
NPI:1235353723
Name:CHARUVASTRA, ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:CHARUVASTRA
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 1:200 PARK AVE S
Mailing Address - Street 2:SUITE 1118 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1503
Mailing Address - Country:US
Mailing Address - Phone:646-389-9871
Mailing Address - Fax:662-735-7492
Practice Address - Street 1:200 PARK AVE S
Practice Address - Street 2:SUITE 1118 B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1503
Practice Address - Country:US
Practice Address - Phone:347-586-0397
Practice Address - Fax:646-304-8412
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2397352084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry