Provider Demographics
NPI:1255395083
Name:CHATTOO, PREMETESH (DO)
Entity type:Individual
Prefix:
First Name:PREMETESH
Middle Name:
Last Name:CHATTOO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 FULTON ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2717
Mailing Address - Country:US
Mailing Address - Phone:212-361-9571
Mailing Address - Fax:212-257-7087
Practice Address - Street 1:122 FULTON ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2717
Practice Address - Country:US
Practice Address - Phone:212-361-9571
Practice Address - Fax:212-257-7087
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2324841174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist