Provider Demographics
NPI:1730139734
Name:M. SALEEM CHOUDHRY, MD, PC
Entity Type:Organization
Organization Name:M. SALEEM CHOUDHRY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:M SALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-897-4350
Mailing Address - Street 1:841 ROUTE 52
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1516
Mailing Address - Country:US
Mailing Address - Phone:845-897-4350
Mailing Address - Fax:845-897-2378
Practice Address - Street 1:841 ROUTE 52
Practice Address - Street 2:SUITE 2
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1516
Practice Address - Country:US
Practice Address - Phone:845-897-4350
Practice Address - Fax:845-897-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125839207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00235121Medicaid
NYC08721Medicare UPIN
NY00235121Medicaid