Provider Demographics
NPI:1417189218
Name:CHICHRA, ASTHA
Entity Type:Individual
Prefix:DR
First Name:ASTHA
Middle Name:
Last Name:CHICHRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208057
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8057
Mailing Address - Country:US
Mailing Address - Phone:203-737-4612
Mailing Address - Fax:203-785-3826
Practice Address - Street 1:789 HOWARD AVE BLDG 2ND
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-785-4198
Practice Address - Fax:203-785-5463
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT57163207RP1001X, 207RC0200X
LAMD.208050207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease