Provider Demographics
NPI:1750482667
Name:DIXIT, CHAITANYA V (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHAITANYA
Middle Name:V
Last Name:DIXIT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 W 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4413
Mailing Address - Country:US
Mailing Address - Phone:718-372-0400
Mailing Address - Fax:718-372-0730
Practice Address - Street 1:2235 W 9TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4413
Practice Address - Country:US
Practice Address - Phone:718-372-0400
Practice Address - Fax:718-372-0730
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0048801213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01261292Medicaid
U29847Medicare UPIN
NY01261292Medicaid