Provider Demographics
NPI:1043295413
Name:CHOWDHURY, ATAUL HAKIM (MD)
Entity Type:Individual
Prefix:
First Name:ATAUL
Middle Name:HAKIM
Last Name:CHOWDHURY
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 1:1888 WESTCHESTER AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-3000
Mailing Address - Country:US
Mailing Address - Phone:917-634-9600
Mailing Address - Fax:888-776-0872
Practice Address - Street 1:1888 WESTCHESTER AVE # B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-3000
Practice Address - Country:US
Practice Address - Phone:917-634-9600
Practice Address - Fax:888-776-0872
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36174207R00000X
NY256970207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ147851Medicaid
NYA03236633Medicaid
NY03236633Medicaid
AZ147851Medicaid