Provider Demographics
NPI:1043286727
Name:CHOUDHRI, TANVIR F (MD)
Entity Type:Individual
Prefix:DR
First Name:TANVIR
Middle Name:F
Last Name:CHOUDHRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 1136B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-0002
Mailing Address - Fax:212-831-3250
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-0002
Practice Address - Fax:212-831-3250
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214433174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02151917Medicaid
NYH47120Medicare UPIN
NY02151917Medicaid