Provider Demographics
NPI:1942708458
Name:CHOWDHURY, RAHATH
Entity Type:Individual
Prefix:
First Name:RAHATH
Middle Name:
Last Name:CHOWDHURY
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 1:1515 HAZEN ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1381
Mailing Address - Country:US
Mailing Address - Phone:347-598-4429
Mailing Address - Fax:
Practice Address - Street 1:1515 HAZEN ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1381
Practice Address - Country:US
Practice Address - Phone:347-774-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014214183500000X
NY065358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist