Provider Demographics
NPI:1750934584
Name:CHITRAKAR, SOLAB (MD)
Entity type:Individual
Prefix:
First Name:SOLAB
Middle Name:
Last Name:CHITRAKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 WASHINGTON ST APT 704
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7105
Mailing Address - Country:US
Mailing Address - Phone:872-806-3032
Mailing Address - Fax:
Practice Address - Street 1:171 PILGRIM RD # LIBBY2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5332
Practice Address - Country:US
Practice Address - Phone:617-632-9880
Practice Address - Fax:617-632-9890
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-21
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125074087390200000X
MA3013503390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty