Provider Demographics
NPI:1689651861
Name:CHADDA, KUL DEEP (MD,)
Entity Type:Individual
Prefix:MR
First Name:KUL
Middle Name:DEEP
Last Name:CHADDA
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:374 STOCKHOLM ST
Mailing Address - Street 2:SUITE 3-046
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4006
Mailing Address - Country:US
Mailing Address - Phone:718-486-4278
Mailing Address - Fax:718-963-6396
Practice Address - Street 1:374 STOCKHOLM ST
Practice Address - Street 2:SUITE 3-046
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4006
Practice Address - Country:US
Practice Address - Phone:718-486-4278
Practice Address - Fax:718-963-6396
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY116511207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00215834Medicare ID - Type UnspecifiedNEW YORK STATE MEDICAID
NY05425GMedicare ID - Type UnspecifiedGHI MEDICARE
NY296761Medicare ID - Type UnspecifiedEMPIRE MEDICARE SERVICES
NYB12463Medicare UPIN