| Mathew M. Chacko Physician Pc | |
|
222 E Main St Suite 101 Smithtown NY 11787-2871 | |
| (631) 360-0303 | |
| (631) 360-2815 |
| Full Name | Mathew M. Chacko Physician Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 222 E Main St, Smithtown, New York |
| Authorized Official Name and Position | Mathew Meloottu Chacko (PRESIDENT) |
| Authorized Official Contact | 6313600303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mathew M. Chacko Physician Pc 222 E Main St Suite 101 Smithtown NY 11787-2871 Ph: (631) 360-0303 | Mathew M. Chacko Physician Pc 222 E Main St Suite 101 Smithtown NY 11787-2871 Ph: (631) 360-0303 |
| NPI Number | 1912163346 |
|---|---|
| Provider Enumeration Date | 08/05/2008 |
| Last Update Date | 08/05/2008 |
| Medicare PECOS PAC ID | 7810063781 |
|---|---|
| Medicare Enrollment ID | O20080829000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912163346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Mathew M Chacko |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407956907 PECOS PAC ID: 2668546490 Enrollment ID: I20080728000722 |
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