Provider Demographics
NPI:1881676609
Name:CHOWDHURY, MOHAMMED S (DPM)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:S
Last Name:CHOWDHURY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MARTINE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3403
Mailing Address - Country:US
Mailing Address - Phone:914-997-2601
Mailing Address - Fax:914-437-9426
Practice Address - Street 1:200 MARTINE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3403
Practice Address - Country:US
Practice Address - Phone:914-997-2601
Practice Address - Fax:914-437-9426
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005878213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU91908Medicare UPIN