Provider Demographics
NPI:1598014763
Name:CHAUDHURI, RUPALI RAY (FNP-C)
Entity Type:Individual
Prefix:
First Name:RUPALI
Middle Name:RAY
Last Name:CHAUDHURI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 S. ELISEO DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904
Mailing Address - Country:US
Mailing Address - Phone:504-821-2601
Mailing Address - Fax:504-373-5464
Practice Address - Street 1:1341 S. ELISEO DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904
Practice Address - Country:US
Practice Address - Phone:504-821-2601
Practice Address - Fax:504-373-5464
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF0812405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily