Provider Demographics
NPI:1699910117
Name:CHAKRABARTI, SIBU
Entity type:Individual
Prefix:MR
First Name:SIBU
Middle Name:
Last Name:CHAKRABARTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 EAST 79TH STREET
Mailing Address - Street 2:APT.10X
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075
Mailing Address - Country:US
Mailing Address - Phone:212-717-4899
Mailing Address - Fax:
Practice Address - Street 1:304 ELLERY STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-782-9345
Practice Address - Fax:718-782-3839
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist