Provider Demographics
NPI:1699833343
Name:SATI, CHETAN (DO)
Entity Type:Individual
Prefix:
First Name:CHETAN
Middle Name:
Last Name:SATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-2740
Mailing Address - Country:US
Mailing Address - Phone:516-795-8446
Mailing Address - Fax:516-795-2981
Practice Address - Street 1:1231 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3104
Practice Address - Country:US
Practice Address - Phone:631-667-0388
Practice Address - Fax:631-968-7705
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3151107OtherCIGNA
201285536OtherUNITED HEALTHCARE
P2462441OtherOXFORD
218705OtherHIP
3767P1OtherBLUE CROSS BLUE SHIELD
201285536OtherEMPIRE
201285536OtherMAGNACARE
283104OtherVYTRA
5995635OtherGHI
7351234OtherAETNA