Provider Demographics
NPI:1295963072
Name:CHATTERJEE, SAURAV (MD, FACC, FSCAI)
Entity type:Individual
Prefix:DR
First Name:SAURAV
Middle Name:
Last Name:CHATTERJEE
Suffix:
Gender:M
Credentials:MD, FACC, FSCAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N BROAD ST
Mailing Address - Street 2:APT 18H
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:267-512-4334
Mailing Address - Fax:
Practice Address - Street 1:124 W 60TH ST
Practice Address - Street 2:APT 18H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7451
Practice Address - Country:US
Practice Address - Phone:859-433-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274314-1207R00000X, 207UN0901X, 207RI0011X
CT56587207RI0011X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program