Provider Demographics
NPI:1932282936
Name:CHAKRABARTI, ANIKET (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIKET
Middle Name:
Last Name:CHAKRABARTI
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:PO BOX 288
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-0288
Mailing Address - Country:US
Mailing Address - Phone:781-826-2424
Mailing Address - Fax:781-412-2500
Practice Address - Street 1:243 CHURCH ST
Practice Address - Street 2:SUITE E
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359
Practice Address - Country:US
Practice Address - Phone:781-826-3838
Practice Address - Fax:781-826-3846
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9712062Medicaid
MA030375949OtherTAX ID
MA030375949OtherTAX ID
MAA30693Medicare PIN