Provider Demographics
NPI:1669456935
Name:RAGHAVAN, CHITRA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHITRA
Middle Name:
Last Name:RAGHAVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHITRA
Other - Middle Name:KUMARI
Other - Last Name:RAJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:6 DEVOE PL
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3601
Mailing Address - Country:US
Mailing Address - Phone:914-506-0449
Mailing Address - Fax:
Practice Address - Street 1:10 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5214
Practice Address - Country:US
Practice Address - Phone:914-637-2063
Practice Address - Fax:914-365-6307
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169836207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01216417Medicaid
NYA60055Medicare UPIN
NY03E59YRXP1Medicare PIN
NY03E59ZT5H1Medicare PIN
NY03E59ZXWW1Medicare PIN
NY01216417Medicaid
NY06509TMedicare PIN
NY03E591Medicare PIN