Individual
KRISTINA RACHEL CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(888) 795-4837
Mailing address
111 E 210TH ST, ROSENTHAL 2C, BRONX, NY 10467
(888) 795-4837
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
253040
NY
207RI0008X
Hepatology Physician
253040
NY
207RT0003X
Transplant Hepatology Physician
Primary
253040
NY
Other
Enumeration date
02/06/2008
Last updated
08/21/2019
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