Basic Information
| Provider Information | |||||||||
| NPI: | 1023152659 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHANDRA SACHETI, MD, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 561 TALCOTTVILLE RD | ||||||||
| Address2: | |||||||||
| City: | VERNON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060662311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608712016 | ||||||||
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| Practice Location | |||||||||
| Address1: | 561 TALCOTTVILLE RD | ||||||||
| Address2: | |||||||||
| City: | VERNON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060662311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608712016 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2007 | ||||||||
| LastUpdateDate: | 03/06/2009 | ||||||||
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| AuthorizedOfficialLastName: | SACHETI | ||||||||
| AuthorizedOfficialFirstName: | CHANDRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8608712016 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | C03298 | 01 | CT | MEDICARE GROUP NUMBER | OTHER |