Provider Demographics
NPI:1497749022
Name:CHAUDHRY, HARVINDER KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVINDER
Middle Name:KAUR
Last Name:CHAUDHRY
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 1:23 MINISINK TRL
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6944
Mailing Address - Country:US
Mailing Address - Phone:845-457-3979
Mailing Address - Fax:
Practice Address - Street 1:20 WALNUT ST
Practice Address - Street 2:SUITE A
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2230
Practice Address - Country:US
Practice Address - Phone:845-457-3979
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01126829Medicaid
NYA98639Medicare UPIN
NY06E111Medicare ID - Type Unspecified