Provider Demographics
NPI:1790417418
Name:CHOUDHARY, ANKUR
Entity Type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:CHOUDHARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 S ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5913
Mailing Address - Country:US
Mailing Address - Phone:814-861-2443
Mailing Address - Fax:
Practice Address - Street 1:1441 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1864
Practice Address - Country:US
Practice Address - Phone:484-526-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program