Provider Demographics
NPI:1932111481
Name:CHANDA, KABERI (MD)
Entity Type:Individual
Prefix:DR
First Name:KABERI
Middle Name:
Last Name:CHANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4552
Mailing Address - Country:US
Mailing Address - Phone:203-459-0408
Mailing Address - Fax:203-459-0494
Practice Address - Street 1:888 WHITE PLAINS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4552
Practice Address - Country:US
Practice Address - Phone:203-459-0408
Practice Address - Fax:203-459-0494
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTH11045Medicare UPIN
CT110008822Medicare PIN