Provider Demographics
NPI:1417658493
Name:CHOUDHURY, RUHEL
Entity Type:Individual
Prefix:
First Name:RUHEL
Middle Name:
Last Name:CHOUDHURY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14814 85TH DR
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2811
Mailing Address - Country:US
Mailing Address - Phone:213-322-3477
Mailing Address - Fax:
Practice Address - Street 1:10609 GUY R BREWER BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-2118
Practice Address - Country:US
Practice Address - Phone:213-322-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225800000X, 372600000X, 374U00000X, 376J00000X, 171400000X
NY156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No372600000XNursing Service Related ProvidersAdult Companion
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker