Provider Demographics
NPI:1710942644
Name:CHATURVEDI, GOVIND PRAKASH (MD)
Entity Type:Individual
Prefix:DR
First Name:GOVIND
Middle Name:PRAKASH
Last Name:CHATURVEDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:33 GRAND ST STE 39B
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3933
Mailing Address - Country:US
Mailing Address - Phone:845-331-4282
Mailing Address - Fax:845-331-4380
Practice Address - Street 1:33 GRAND ST STE 39B
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3933
Practice Address - Country:US
Practice Address - Phone:845-331-4282
Practice Address - Fax:845-331-4380
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159759207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103446OtherWELLCARE
NY00941460Medicaid
NY047112OtherMVP
NY59D261OtherMATRIX
NY805571OtherMETLIFE
NY10032289OtherCDPHP
NY80123000001595OtherB/S OF NY
NYPM6284OtherHEALTH NET
NY000000003446OtherGHI HMO
NY0068864OtherGHI
NY159759-0OtherWORKMANS COMP
NY59D261Medicare PIN
NY0068864OtherGHI