MEDICARE: JUDY RAMUS CHOWDRY M.S.P.T

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
1	225100000X	Physical Therapist	05003435A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200655400	OTHER	IN	LPI NUMBER

General Provider Information

NPI Number	:	1629296819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY RAMUS CHOWDRY M.S.P.T

Provider Business Mailing Address
First Line	:	902 E 51ST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1118
Country	:	US
Telephone Number	:	317-242-8508
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 E 51ST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1118
Country	:	US
Telephone Number	:	317-242-8508
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	11/05/2010

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