Provider Demographics
NPI:1346380763
Name:CHANDRA K. SACHETI, M.D., LLC
Entity Type:Organization
Organization Name:CHANDRA K. SACHETI, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SACHETI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-871-2016
Mailing Address - Street 1:561 TALCOTTVILLE RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-2311
Mailing Address - Country:US
Mailing Address - Phone:860-871-2016
Mailing Address - Fax:860-870-5451
Practice Address - Street 1:561 TALCOTTVILLE RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-2311
Practice Address - Country:US
Practice Address - Phone:860-871-2016
Practice Address - Fax:860-870-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018588174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03298Medicare ID - Type Unspecified