Provider Demographics
NPI:1912010018
Name:CHAWLA, KABU (MD)
Entity Type:Individual
Prefix:DR
First Name:KABU
Middle Name:
Last Name:CHAWLA
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 1:953 49TH ST
Mailing Address - Street 2:SUITE 511
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2923
Mailing Address - Country:US
Mailing Address - Phone:718-283-8380
Mailing Address - Fax:718-283-7884
Practice Address - Street 1:953 49TH ST
Practice Address - Street 2:SUITE 511
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2923
Practice Address - Country:US
Practice Address - Phone:718-283-8380
Practice Address - Fax:718-283-7884
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214601207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02168587Medicaid
NYH44201Medicare UPIN
NY22R721Medicare ID - Type Unspecified