Individual
CHITRA RADHAKRISHNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9201 4TH AVE STE 501, BROOKLYN, NY 11209-7065
(718) 921-2500
(718) 238-2558
Mailing address
9201 4TH AVE STE 501, BROOKLYN, NY 11209-7065
(718) 921-2500
(718) 238-2558
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036.117757
IL
207W00000X
Ophthalmology Physician
Primary
244377
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117757
—
IL
01
—
04901134
BLUE CROSS BLUE SHIELD OF IL
IL
01
—
1770656787
GROUP NPI
IL
01
—
1770773012
INDIVIDUAL NPI #
IL
01
—
DG5819
RAILROAD MEDICARE GROUP #
IL
Enumeration date
08/01/2007
Last updated
03/29/2018
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