Provider Demographics
NPI:1922050558
Name:CHOWDHRY, MOHAMMED I
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:I
Last Name:CHOWDHRY
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 1:357 BEACH 89TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1408
Mailing Address - Country:US
Mailing Address - Phone:718-318-1090
Mailing Address - Fax:718-318-4953
Practice Address - Street 1:357 BEACH 89TH ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1408
Practice Address - Country:US
Practice Address - Phone:718-318-1090
Practice Address - Fax:718-318-4953
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY136703207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00707144Medicaid
NY00707144Medicaid
NY84692BMedicare ID - Type Unspecified