Provider Demographics
NPI:1912027582
Name:CHAKRABORTY, AUROBINDO (MD)
Entity Type:Individual
Prefix:DR
First Name:AUROBINDO
Middle Name:
Last Name:CHAKRABORTY
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 1:190 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2057
Mailing Address - Country:US
Mailing Address - Phone:508-647-1600
Mailing Address - Fax:508-647-1695
Practice Address - Street 1:190 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2057
Practice Address - Country:US
Practice Address - Phone:508-647-1600
Practice Address - Fax:508-647-1695
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73717207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9773894Medicaid
MAJ13159Medicare ID - Type Unspecified
MA9773894Medicaid