Provider Demographics
NPI:1902996572
Name:CHOPRA, MOHIT PAWAN (MD)
Entity Type:Individual
Prefix:
First Name:MOHIT
Middle Name:PAWAN
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3666
Mailing Address - Country:US
Mailing Address - Phone:781-708-3832
Mailing Address - Fax:
Practice Address - Street 1:178 SAVIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-2329
Practice Address - Country:US
Practice Address - Phone:781-338-7250
Practice Address - Fax:781-338-7245
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-42312084P0800X, 2084P0805X
MA2383702084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR155874001Medicaid
ARP00265144OtherMEDICARE RAILROAD
AR155874001Medicaid
5N004Medicare PIN