Provider Demographics
NPI:1407902505
Name:PREM C CHATPAR MD LLC
Entity Type:Organization
Organization Name:PREM C CHATPAR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PREM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHATPAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-931-3988
Mailing Address - Street 1:524 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6502
Mailing Address - Country:US
Mailing Address - Phone:516-931-3988
Mailing Address - Fax:
Practice Address - Street 1:524 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6502
Practice Address - Country:US
Practice Address - Phone:516-931-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146380207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B17043Medicare UPIN