Provider Demographics
NPI:1972679447
Name:CHACKO, BIJO (MD)
Entity Type:Individual
Prefix:DR
First Name:BIJO
Middle Name:
Last Name:CHACKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:484 TEMPLE HILL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-5557
Mailing Address - Country:US
Mailing Address - Phone:845-565-3700
Mailing Address - Fax:845-565-3696
Practice Address - Street 1:484 TEMPLE HILL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5557
Practice Address - Country:US
Practice Address - Phone:845-565-3700
Practice Address - Fax:844-556-5369
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY230770207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine