Healthcare Provider Details

I. General information

NPI: 1619097805
Provider Name (Legal Business Name): ARUN CHAUDHURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEST ROXBURY VA MEDICAL CENTER 1400 VFW PARKWAY, ROOM 2B101
WEST ROXBURY MA
02132
US

IV. Provider business mailing address

5118 WASHINGTON ST APT#3, RIDGECREST TERRACE
WEST ROXBURY MA
02132-5248
US

V. Phone/Fax

Practice location:
  • Phone: 617-323-7700
  • Fax:
Mailing address:
  • Phone: 617-390-5526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: