Individual
TRESA CHAKKALAKKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
653 N TOWN CENTER DR, SUITE 106, LAS VEGAS, NV 89144-0514
(702) 363-3000
(702) 363-3161
Mailing address
11218 APPLEVALE CT, LAS VEGAS, NV 89138-8010
(718) 334-6793
(718) 334-6717
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
002415
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2682259
—
NY
Enumeration date
04/12/2007
Last updated
10/12/2012
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