DR. MATHEW MELOOTTU CHACKO MD NPI 1407956907

NPI Information

NPI: 1407956907
Provider Name: DR. MATHEW MELOOTTU CHACKO, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
222 E MAIN ST
SIUTE 101
SMITHTOWN, NY
ZIP 11787
Phone: (631) 360-0303
Get Directions

DR. Mathew Meloottu Chacko, MD is a neurology psychiatry neurology in Smithtown, NY. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. DR. Mathew Meloottu Chacko, MD NPI is 1407956907. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

222 E MAIN ST
SIUTE 101
SMITHTOWN, NY
ZIP 11787-871
Phone: (631) 360-0303
Fax: (631) 360-2815

The NPI 1407956907 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/24/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	149174	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	CO9698	MEDICARE UPIN	NEW YORK
2	42D571	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
3	00893614	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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