Provider Demographics
NPI:1750353603
Name:ALAKANANDA CHAKRABARTY MDPC
Entity type:Organization
Organization Name:ALAKANANDA CHAKRABARTY MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAKANANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKRABARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-648-0424
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH071756Medicare ID - Type Unspecified