Healthcare Provider Details

I. General information

NPI: 1497749022
Provider Name (Legal Business Name): HARVINDER KAUR CHAUDHRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WALNUT ST SUITE A
MONTGOMERY NY
12549-2230
US

IV. Provider business mailing address

23 MINISINK TRL
GOSHEN NY
10924-6944
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number163072
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: