Provider Demographics
NPI:1710257837
Name:BINA CHAUDHARI-MODY, MD PC
Entity Type:Organization
Organization Name:BINA CHAUDHARI-MODY, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI-MODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-539-6222
Mailing Address - Street 1:4370 KISSENA BLVD # 1L
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4370 KISSENA BLVD # 1L
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3769
Practice Address - Country:US
Practice Address - Phone:718-539-6222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211043207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01937008Medicaid