Provider Demographics
NPI:1700970654
Name:CHAKOTE, JYOTI M (MD)
Entity Type:Individual
Prefix:MS
First Name:JYOTI
Middle Name:M
Last Name:CHAKOTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8820 ROCKAWAY BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1608
Mailing Address - Country:US
Mailing Address - Phone:718-634-8080
Mailing Address - Fax:718-945-6706
Practice Address - Street 1:8820 ROCKAWAY BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1608
Practice Address - Country:US
Practice Address - Phone:718-634-8080
Practice Address - Fax:718-634-8087
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY208000OtherLICENSE
NYH11772Medicare UPIN