Basic Information
| Provider Information | |||||||||
| NPI: | 1699833343 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SATI | ||||||||
| FirstName: | CHETAN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | MASSAPEQUA PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117622740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167958446 | ||||||||
| FaxNumber: | 5167952981 | ||||||||
| Practice Location | |||||||||
| Address1: | 1231 DEER PARK AVE | ||||||||
| Address2: | |||||||||
| City: | NORTH BABYLON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117033104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316670388 | ||||||||
| FaxNumber: | 6319687705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 06/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 218705 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3151107 | 01 | CIGNA | OTHER | 201285536 | 01 | UNITED HEALTHCARE | OTHER | P2462441 | 01 | OXFORD | OTHER | 218705 | 01 | HIP | OTHER | 3767P1 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 201285536 | 01 | EMPIRE | OTHER | 201285536 | 01 | MAGNACARE | OTHER | 283104 | 01 | VYTRA | OTHER | 5995635 | 01 | GHI | OTHER | 7351234 | 01 | AETNA | OTHER |