Provider Demographics
NPI:1396771010
Name:ROY, CHITRITA G (MD)
Entity type:Individual
Prefix:DR
First Name:CHITRITA
Middle Name:G
Last Name:ROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:404 W MISSION AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-5173
Mailing Address - Country:US
Mailing Address - Phone:402-991-5437
Mailing Address - Fax:402-991-5497
Practice Address - Street 1:404 W MISSION AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-5173
Practice Address - Country:US
Practice Address - Phone:402-991-5437
Practice Address - Fax:402-991-5497
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE19429208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100250684-00Medicaid
NEF93168Medicare UPIN