Healthcare Provider Details

I. General information

NPI: 1861657108
Provider Name (Legal Business Name): BILAL IFTIKHAR CHUGHTAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 06/11/2023
Certification Date: 06/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E 61ST ST FL 12
NEW YORK NY
10065
US

IV. Provider business mailing address

425 E 61ST ST FL 12
NEW YORK NY
10065-8722
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-4811
  • Fax: 646-962-0140
Mailing address:
  • Phone: 646-962-4811
  • Fax: 646-962-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number256141
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number256141
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: