Provider Demographics
NPI:1902818842
Name:CHITKARA, AJAY EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:EARL
Last Name:CHITKARA
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 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:1500 ROUTE 112
Practice Address - Street 2:BLDG. 4 - 2ND FLOOR
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-8054
Practice Address - Country:US
Practice Address - Phone:631-828-7001
Practice Address - Fax:631-928-0185
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228329207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01203602OtherRAILROAD MEDICARE PIN
NYP01203602OtherRAILROAD MEDICARE PIN
NYI01133Medicare UPIN