Provider Demographics
NPI:1275115560
Name:GOHAL, CHETAN (MD)
Entity type:Individual
Prefix:DR
First Name:CHETAN
Middle Name:
Last Name:GOHAL
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 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:484-214-6604
Mailing Address - Fax:
Practice Address - Street 1:645 MADISON AVE FL 34
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1010
Practice Address - Country:US
Practice Address - Phone:888-636-7840
Practice Address - Fax:267-479-1321
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11781700207X00000X
IL125.077274207XX0005X
NY321046207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine