Provider Demographics
NPI:1477753275
Name:CHUTANI, SURENDRA KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:SURENDRA
Middle Name:KUMAR
Last Name:CHUTANI
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 1:955 YONKERS AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3062
Mailing Address - Country:US
Mailing Address - Phone:914-237-4720
Mailing Address - Fax:914-920-3050
Practice Address - Street 1:955 YONKERS AVE STE 103
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3062
Practice Address - Country:US
Practice Address - Phone:914-237-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2018-03-08
Deactivation Date:2017-12-22
Deactivation Code:
Reactivation Date:2018-01-23
Provider Licenses
StateLicense IDTaxonomies
NY2857641207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease