Individual
DR. CHINTAMAN SADASHIVA PHATAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10210 66TH ROAD, #1B FOREST HILLS, NEW YORK, NY 11375-1004
(718) 896-6141
(516) 621-0193
Mailing address
10210 66TH ROAD, #1B FOREST HILLS, NEW YORK, NY 11375-1004
(718) 896-6141
(516) 621-0193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
115908
NY
207R00000X
Internal Medicine Physician
115908
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
753755
AETNA INSURANCE
—
Enumeration date
04/13/2007
Last updated
09/11/2025
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