Individual
MARILYN CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5506
Mailing address
396 MENAHAN ST, RIDGEWOOD, NY 11385-2120
(917) 755-6242
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
304436
NY
Other
Enumeration date
05/11/2017
Last updated
10/04/2021
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