Healthcare Provider Details

I. General information

NPI: 1891069860
Provider Name (Legal Business Name): HARVINDER K. CHAUDHRY MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WALNUT ST
MONTGOMERY NY
12549-2260
US

IV. Provider business mailing address

20 WALNUT ST
MONTGOMERY NY
12549-2260
US

V. Phone/Fax

Practice location:
  • Phone: 845-457-3979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CLAUDETTE SCHAAD
Title or Position: OFFICE MANAGER
Credential:
Phone: 845-457-3979