Provider Demographics
NPI:1144305954
Name:N.R. CHANDRASEKAR, M.D., P.C.
Entity type:Organization
Organization Name:N.R. CHANDRASEKAR, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:N. R.
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRASEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-864-8088
Mailing Address - Street 1:300 MOUNT AUBURN STREET, SUITE 510
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02238
Mailing Address - Country:US
Mailing Address - Phone:617-864-8088
Mailing Address - Fax:617-902-2700
Practice Address - Street 1:300 MOUNT AUBURN STREET, SUITE 510
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02238
Practice Address - Country:US
Practice Address - Phone:617-864-8088
Practice Address - Fax:617-864-4351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1505952086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
21740OtherHARVARD PILGRIM
794620OtherTUFTS
J17133OtherBCBS
MA3178579Medicaid
794620OtherTUFTS
A34471Medicare PIN