Provider Demographics
NPI:1477663144
Name:CHOUDHRI, HAROON F (MD)
Entity Type:Individual
Prefix:
First Name:HAROON
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 1:1088 N BROADWAY STE 101
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1107
Mailing Address - Country:US
Mailing Address - Phone:914-233-9716
Mailing Address - Fax:
Practice Address - Street 1:1088 N BROADWAY STE 101
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1107
Practice Address - Country:US
Practice Address - Phone:914-233-9716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049378207T00000X
NY214626207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA14BDCHSMedicare ID - Type UnspecifiedGA MEDICARE #
H28195Medicare UPIN
H28195Medicare UPIN
GA000885464AMedicaid