Provider Demographics
NPI:1205808151
Name:CHAKRABARTY, ALAKANANDA (MD)
Entity type:Individual
Prefix:DR
First Name:ALAKANANDA
Middle Name:
Last Name:CHAKRABARTY
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 1:101 HAKES ST
Mailing Address - Street 2:
Mailing Address - City:COAL TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:17866-3829
Mailing Address - Country:US
Mailing Address - Phone:570-648-0424
Mailing Address - Fax:570-648-3560
Practice Address - Street 1:101 HAKES ST
Practice Address - Street 2:
Practice Address - City:COAL TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:17866-3829
Practice Address - Country:US
Practice Address - Phone:570-648-0424
Practice Address - Fax:570-648-3560
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065076L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG96076Medicare UPIN
PACH028141Medicare ID - Type Unspecified