Provider Demographics
NPI:1366821324
Name:CHAUHAN, CHETAN (MD)
Entity Type:Individual
Prefix:
First Name:CHETAN
Middle Name:
Last Name:CHAUHAN
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 1:169 WYTHE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3102
Mailing Address - Country:US
Mailing Address - Phone:844-384-2779
Mailing Address - Fax:
Practice Address - Street 1:169 WYTHE AVE APT 104
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-3102
Practice Address - Country:US
Practice Address - Phone:844-384-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-23
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015011822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry