Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 209795 | NY |
N | 207VG0400X | Gynecologist | 209795 | NY |
N | 207VX0000X | Obstetrician | 209795 | NY |
NPI | 1245327345 |
---|---|
Provider Name | Sarah Chacko |
First Address | New York, NY 10023-4163 |
Second Address | New York, NY 10023-4163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H15098 | (02) | NY |