Provider Demographics
NPI:1710900410
Name:CHANDY, DIPAK (MD)
Entity Type:Individual
Prefix:
First Name:DIPAK
Middle Name:
Last Name:CHANDY
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 1:95 GRASSLANDS RD-NYMC
Mailing Address - Street 2:DEPT OF MEDICINE
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-7517
Mailing Address - Fax:914-594-4434
Practice Address - Street 1:95 GRASSLANDS RD-NYMC
Practice Address - Street 2:DEPT OF MEDICINE-MACY PAVILION
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7517
Practice Address - Fax:914-594-4434
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000919207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2102215OtherGHI PPO
P00067348OtherRAILROAD MEDICARE
NY5C6275OtherHEALTHNET
NY7224129OtherAETNA PPO
P1584044OtherOXFORD
133277785OtherNOVA HEALTHCARE
321631OtherMVP
NY59N021OtherBCBS OF NY
NY00000051714OtherGHI HMO
000919OtherHIP
NY02052899Medicaid
NY2189062OtherAETNA HMO