Provider Demographics
NPI:1790763530
Name:CHUDOW, STERLING (MD)
Entity Type:Individual
Prefix:DR
First Name:STERLING
Middle Name:
Last Name:CHUDOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-2649
Mailing Address - Country:US
Mailing Address - Phone:845-986-9986
Mailing Address - Fax:845-783-7133
Practice Address - Street 1:24 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-2649
Practice Address - Country:US
Practice Address - Phone:845-986-9986
Practice Address - Fax:845-783-7133
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131033207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B15174Medicare UPIN