Provider Demographics
NPI:1366489551
Name:CHOWLERA, KUSUM NATWARLAL (MD)
Entity Type:Individual
Prefix:DR
First Name:KUSUM
Middle Name:NATWARLAL
Last Name:CHOWLERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8028 LEFFERTS BLVD
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1724
Mailing Address - Country:US
Mailing Address - Phone:718-441-8426
Mailing Address - Fax:
Practice Address - Street 1:2802 21ST AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2926
Practice Address - Country:US
Practice Address - Phone:718-728-6257
Practice Address - Fax:718-545-3638
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00809614Medicaid
3D782Medicare ID - Type Unspecified
NY00809614Medicaid