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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407956907 NPPES
New York MEDICAID 00893614

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