Provider Demographics
NPI:1750339404
Name:CHAGLA, DILSHAD F (MD)
Entity type:Individual
Prefix:
First Name:DILSHAD
Middle Name:F
Last Name:CHAGLA
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 1:585 SCHENECTADY AVE
Mailing Address - Street 2:MANAGED CARE DEPT. - 6TH FLOOR, BLUMBERG BLDG
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1809
Mailing Address - Country:US
Mailing Address - Phone:718-604-5469
Mailing Address - Fax:718-604-5527
Practice Address - Street 1:585 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1809
Practice Address - Country:US
Practice Address - Phone:718-604-5388
Practice Address - Fax:718-604-5527
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255058207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI25986Medicare UPIN
NY084SR1Medicare PIN