Provider Demographics
NPI:1255588109
Name:CHAKRABORTY, SAMHITA (MD)
Entity type:Individual
Prefix:MS
First Name:SAMHITA
Middle Name:
Last Name:CHAKRABORTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S ORANGE AVE
Mailing Address - Street 2:SUITE A 1115, CANCER CENTER
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2785
Mailing Address - Country:US
Mailing Address - Phone:973-972-6257
Mailing Address - Fax:973-972-8390
Practice Address - Street 1:205 S ORANGE AVE
Practice Address - Street 2:SUITE A 1115, CANCER CENTER
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2785
Practice Address - Country:US
Practice Address - Phone:973-972-6257
Practice Address - Fax:973-972-8390
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08464500207R00000X, 207RH0003X
NY250284-1207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine