Provider Demographics
NPI:1962827683
Name:BHANWARLAL CHOWDHURY MD PA
Entity Type:Organization
Organization Name:BHANWARLAL CHOWDHURY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHANWARLAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-393-1888
Mailing Address - Street 1:1757 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-6007
Mailing Address - Country:US
Mailing Address - Phone:609-393-1888
Mailing Address - Fax:609-396-9234
Practice Address - Street 1:1757 S BROAD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-6007
Practice Address - Country:US
Practice Address - Phone:609-393-1888
Practice Address - Fax:609-396-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03284900207RG0100X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1075725OtherHORIZON NJ HEALTH
NJ204792OtherUNITED HEALTHCARE
NJ2991705Medicaid
NJF06507OtherHEALTHNET
NJ0072462000OtherAMERIHEALTH
NJ1013950003OtherCIGNA
NJP1679696OtherOXFORD
NJ1013950003OtherCIGNA
NJF07866Medicare UPIN