Provider Demographics
NPI:1497056790
Name:CHOUDHURY, TARIF (MD)
Entity Type:Individual
Prefix:DR
First Name:TARIF
Middle Name:
Last Name:CHOUDHURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TARIF
Other - Middle Name:
Other - Last Name:CHOUDHURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:175 E 96TH ST
Mailing Address - Street 2:APT 20G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6200
Mailing Address - Country:US
Mailing Address - Phone:646-236-7847
Mailing Address - Fax:
Practice Address - Street 1:175 E 96TH ST
Practice Address - Street 2:APT 20G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6200
Practice Address - Country:US
Practice Address - Phone:646-236-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2765632080P0202X, 208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics