Provider Demographics
NPI:1518308220
Name:CHANDRA, SUBHAS (MD)
Entity Type:Individual
Prefix:
First Name:SUBHAS
Middle Name:
Last Name:CHANDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SUBHAS
Other - Middle Name:
Other - Last Name:CHANDRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1211 WHITE PLAINS RD
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-4900
Mailing Address - Country:US
Mailing Address - Phone:718-828-6610
Mailing Address - Fax:
Practice Address - Street 1:1211 WHITE PLAINS RD
Practice Address - Street 2:BRONX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-4900
Practice Address - Country:US
Practice Address - Phone:718-828-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270664207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine