Healthcare Provider Details

I. General information

NPI: 1962827683
Provider Name (Legal Business Name): BHANWARLAL CHOWDHURY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COURTNEY DR
PRINCETON JUNCTION NJ
08550-1316
US

IV. Provider business mailing address

1757 S BROAD ST
TRENTON NJ
08610-6007
US

V. Phone/Fax

Practice location:
  • Phone: 609-575-3002
  • Fax: 609-396-9234
Mailing address:
  • Phone: 609-393-1888
  • Fax: 609-396-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MA03284900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number25MA03284900
License Number StateNJ

VIII. Authorized Official

Name: DR. BHANWARLAL CHOWDHURY
Title or Position: PRESIDENT
Credential: MD
Phone: 609-393-1888