Provider Demographics
NPI:1467899971
Name:AMERICHETTY, CHANDRAREKHA (MD)
Entity Type:Individual
Prefix:
First Name:CHANDRAREKHA
Middle Name:
Last Name:AMERICHETTY
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 1:197 S UNION RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6569
Mailing Address - Country:US
Mailing Address - Phone:201-443-6317
Mailing Address - Fax:201-443-6317
Practice Address - Street 1:197 S UNION RD
Practice Address - Street 2:UNIT B
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6569
Practice Address - Country:US
Practice Address - Phone:201-443-6317
Practice Address - Fax:201-443-6317
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY286516-1207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine