Provider Demographics
NPI:1336573542
Name:CHOWDHURY, NOSHIN (MD)
Entity Type:Individual
Prefix:
First Name:NOSHIN
Middle Name:
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 OLD ORANGEBURG ROAD
Mailing Address - Street 2:BUILDING 57 8TH FLOOR
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1159
Mailing Address - Country:US
Mailing Address - Phone:845-680-8308
Mailing Address - Fax:456-805-5878
Practice Address - Street 1:140 OLD ORANGEBURG RD BLDG 578TH
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1157
Practice Address - Country:US
Practice Address - Phone:845-680-8308
Practice Address - Fax:845-680-5587
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2719532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY271953OtherNEW YORK STATE LICENSE NUMBER
NY1336573542Medicaid