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NPI Code Detail

MEDICARE: DR. MADDIPOTI CHOUDRY M.D.

MEDICARE: DR. MADDIPOTI CHOUDRY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician129945NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053398495
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADDIPOTI CHOUDRY M.D.
Provider Business Mailing Address
First Line : 111 CLOCK TOWER CMNS
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4055
Country : US
Telephone Number : 845-279-5187
Fax Number : 855-703-7570
Provider Business Practice Location Address
First Line : 111 CLOCK TOWER CMNS
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4055
Country : US
Telephone Number : 845-279-5187
Fax Number : 855-703-7570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 01/28/2026

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