Provider Demographics
NPI:1356418511
Name:CHOWDHURY, ASM S (MD)
Entity type:Individual
Prefix:
First Name:ASM
Middle Name:S
Last Name:CHOWDHURY
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 1:564 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1525
Mailing Address - Country:US
Mailing Address - Phone:718-277-2700
Mailing Address - Fax:718-277-4191
Practice Address - Street 1:1084 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2923
Practice Address - Country:US
Practice Address - Phone:718-277-2700
Practice Address - Fax:718-277-4191
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02593699Medicaid
G86937Medicare UPIN
NY47C861Medicare PIN