Provider Demographics
NPI:1043221674
Name:CHOWDARY, SUNEETHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNEETHA
Middle Name:
Last Name:CHOWDARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNITA
Other - Middle Name:KOLLU
Other - Last Name:CHOWDARY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:24156 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2620
Mailing Address - Country:US
Mailing Address - Phone:516-643-2199
Mailing Address - Fax:718-229-1554
Practice Address - Street 1:2801 OCEAN PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:516-643-2199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197956207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01729340Medicaid
NYG46675Medicare UPIN