Chacko, Mathew Meloottu
Chacko, Mathew Meloottu is an sole proprietor health care provider with primary practice located at 222 E Main St Siute 101, Smithtown NY 11787-2871. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Chacko, Mathew Meloottu can be contacted via phone (631) 360-0303.Contact Information
Primary practice address
222 E Main St Siute 101
Smithtown NY 11787-2871
Phone: (631) 360-0303
Fax: (631) 360-2815
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 149174 | New York |
Profile Details
| NPI number | 1407956907 |
|---|---|
| LBN Legal business name | Chacko, Mathew Meloottu |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407956907 | NPPES |
| New York | MEDICAID | 00893614 |
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