Provider Demographics
NPI:1376544817
Name:MUKHERJEE, SATYAJIT (MD)
Entity Type:Individual
Prefix:
First Name:SATYAJIT
Middle Name:
Last Name:MUKHERJEE
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 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:176 S COLDBROOK AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2712
Practice Address - Country:US
Practice Address - Phone:717-267-7480
Practice Address - Fax:717-267-7403
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4174752084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018737580003Medicaid
PA100015949OtherRAILROAD MEDICARE
PAMD417475OtherLICENSE
PA50001294OtherCAPITAL BLUECROSS
PA1007307260034OtherMEDICAID GROUP #
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherMULTIPLAN/PHCS
PA867633OtherMEDICARE GROUP #
PA120420406OtherDEPT OF LABOR
PA1372387OtherHIGHMARK BLUESHIELD
PA25-1716306OtherINFORMED
PA3114864OtherMAMSI
PA379953OtherHEALTH AMERICA
PA25-1716306OtherHEALTHNET/TRICARE
PA25-1716306OtherDEVON
PA1507057OtherAETNA NON-HMO
PA2160061OtherFIRST HEALTH
PA25-1716306OtherINTERGROUP
PA7057412OtherAETNA HMO
PA7057412OtherAETNA HMO
PA25-1716306OtherINFORMED
PA053808LN7Medicare PIN