Individual
DR. RIYA SUSAN CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 OLD FERN HILL RD, BLDG A STE 5, WEST CHESTER, PA 19380-4269
(610) 696-2850
(610) 696-7159
Mailing address
207 N BROAD ST FL 3, PHILADELPHIA, PA 19107-1500
(610) 696-2850
(610) 696-7159
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD470439
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037748040001
—
PA
Enumeration date
07/26/2007
Last updated
07/07/2023
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