Healthcare Provider Details

I. General information

NPI: 1043492713
Provider Name (Legal Business Name): ATUL CHOKSHI PHYSICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 07/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 9TH ST
BROOKLYN NY
11215-4049
US

IV. Provider business mailing address

P.O.BOX 639
ALPINE NJ
07620
US

V. Phone/Fax

Practice location:
  • Phone: 718-499-0202
  • Fax: 718-369-0484
Mailing address:
  • Phone: 201-660-7110
  • Fax: 201-660-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number136973
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number136973
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number136973
License Number StateNY

VIII. Authorized Official

Name: ATUL CHOKSHI
Title or Position: PRESIDENT
Credential:
Phone: 201-660-7110