Provider Demographics
NPI:1255310801
Name:CHAGPAR, ANEES B (MD)
Entity Type:Individual
Prefix:
First Name:ANEES
Middle Name:B
Last Name:CHAGPAR
Suffix:
Gender:F
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:P.O BOX 208237
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8237
Mailing Address - Country:US
Mailing Address - Phone:203-432-0076
Mailing Address - Fax:203-432-7289
Practice Address - Street 1:55 LOCK STREET
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511
Practice Address - Country:US
Practice Address - Phone:203-432-0076
Practice Address - Fax:203-432-7289
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38398208600000X, 2086X0206X
CT049071208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64067192Medicaid
IN200466990Medicaid
KY50001574OtherPASSPORT
H77233Medicare UPIN
KY687824Medicare PIN