Individual
MRS. JAYASREE CHANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
212 E 106 STREET, NEW YORK, NY 10029
(212) 360-2600
(646) 619-8399
Mailing address
212 E 106 STREET, NEW YORK, NY 10029
(212) 360-2600
(646) 619-8399
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD29888
TN
207Q00000X
Family Medicine Physician
Primary
198279
NY
207Q00000X
Family Medicine Physician
198279-1
NY
207Q00000X
Family Medicine Physician
MD29888
TN
207V00000X
Obstetrics & Gynecology Physician
MD29888
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14891
TLC FAMILY HEALTHCARE
TN
05
—
3855243
—
TN
01
—
4121982
TENNCARE SELECT
TN
01
—
621821584
TRICARE
TN
01
—
6848718
CIGNA
TN
Enumeration date
06/11/2006
Last updated
04/25/2017
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