Provider Demographics
NPI:1447229307
Name:CHAKRABARTI, ANJANA (MD)
Entity Type:Individual
Prefix:
First Name:ANJANA
Middle Name:
Last Name:CHAKRABARTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 EAST ST
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844
Mailing Address - Country:US
Mailing Address - Phone:978-689-0869
Mailing Address - Fax:978-689-3096
Practice Address - Street 1:60 EAST ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844
Practice Address - Country:US
Practice Address - Phone:978-689-0869
Practice Address - Fax:978-689-3096
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51559208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3056902Medicaid
MA3056902Medicaid
E35806Medicare UPIN