Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD062159L | PA |
N | 208000000X | Pediatrician | MD062159L | PA |
NPI | 1417965831 |
---|---|
Provider Name | Sulagna Chakraborty Chakraburty Saitta |
First Address | Los Angeles, CA 90010-2814 |
Second Address | West Hollywood, CA 90048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 13/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001836128 | (05) | PA |
8441707 | (05) | NJ |
H33526 | (02) |