Provider Demographics
NPI:1164613139
Name:CHUGH, MULCHAND (MD)
Entity Type:Individual
Prefix:
First Name:MULCHAND
Middle Name:
Last Name:CHUGH
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 1:112 COURT NORTH DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-8100
Mailing Address - Country:US
Mailing Address - Phone:631-270-4401
Mailing Address - Fax:631-930-3231
Practice Address - Street 1:2277 GRAND AVENUE
Practice Address - Street 2:SOUTH NASSAU COMMUNITIES HOSPITAL MENTAL HEALTH COUNSE
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:631-377-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0456172084P0800X
NY2459512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry