Active NPI
Chandrama Mukherjee, PHD
- Psychologist
- Bronx, NY
National Provider Identifier
1851163364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 026028
- Practice address
- 3424 Kossuth Ave
Bronx, NY 10467-2489 - Phone
- (718) 519-5000
- NPI assigned
- Oct 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 026028 | NY | Primary |
Addresses
Primary practice location
3424 Kossuth Ave
Bronx, NY 10467-2489
Mailing address
555 W 152ND St Apt 3a
New York, NY 10031-1616
Phone (402) 840-1839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231228001384 | NY | Order and Referring Only - Clinical Psychologist | 6305296641 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026028 | NY | MD | Occupational Therapist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698364800000",
"number": "1851163364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 W 152ND ST APT 3A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100311616",
"telephone_number": "402-840-1839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3424 KOSSUTH AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672489",
"telephone_number": "718-519-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKHERJEE",
"first_name": "CHANDRAMA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-27",
"last_updated": "2023-10-27",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "026028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.