Healthcare Provider Details

I. General information

NPI: 1356458111
Provider Name (Legal Business Name): SANJAY CHAUBE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE FL 5
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE # 8422
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-1001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number333826
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19207
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: