Rahul Chakraborty, S.T
Individual provider Active NPI Nursing Facility/Intermediate Care Facility · West Lafayette Bra, IN
NPI 1629286372 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629286372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 46001690A (IN)
- Practice address
- 3401 Soldiers Home Rd
West Lafayette Bra, IN 47906-1222 - Phone
- (765) 463-1541
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46001690A | IN | MD | Nursing Facility/Intermediate Care Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 46001690A | IN | Yes |
Addresses
Primary practice location
3401 Soldiers Home Rd
West Lafayette Bra, IN 47906-1222
Mailing address
2400 Northwestern Ave
West Lafayette Bra, IN 47906-1855
Phone (765) 427-7793
Other providers in West Lafayette Bra, IN
- Kathy J Arnold
- Kay Bleyer
- Robert Clifford Bouggy
- Nancy Yeats Brandt
- Mukesh Desai
- Christine Ahl Durbin
- Elizabeth H. Akey, PHD Psychologist
- Jennifer Lynne English
- Alfredo Enriquez Jr.
All providers in West Lafayette Bra, IN · Nursing Facility/Intermediate Care Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.