Provider Demographics
NPI:1730742537
Name:CHACKO, DIANA ELZA (RRT)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ELZA
Last Name:CHACKO
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:423 EAST 23RD STREET
Mailing Address - Street 2:RESPIRATORY CARE SERVICES ROOM 13090S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:212-686-7500
Mailing Address - Fax:212-951-6882
Practice Address - Street 1:423 EAST 23RD STREET
Practice Address - Street 2:RESPIRATORY CARE SERVICES ROOM 13090S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:212-951-6882
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0066282279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care