Provider Demographics
NPI:1578598520
Name:CHORDIA, PRATAP UTTAMCHAND (MD)
Entity Type:Individual
Prefix:
First Name:PRATAP
Middle Name:UTTAMCHAND
Last Name:CHORDIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PRATAP
Other - Middle Name:UTTAMCHAND
Other - Last Name:CHORDIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27391
Mailing Address - Street 2:ANES ASSOC OF MOUNT KISCO
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7391
Mailing Address - Country:US
Mailing Address - Phone:800-720-1664
Mailing Address - Fax:207-753-2020
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:ANES ASSOC OF MOUNT KISCO
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-4050
Practice Address - Fax:914-666-5012
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140757207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA050019185OtherRR MEDICARE
NY00639047Medicaid
NY00639047Medicaid
NY50A691Medicare PIN
NY50A69LL891Medicare PIN
GA050019185Medicare PIN
NY50A691Medicare ID - Type Unspecified