Healthcare Provider Details

I. General information

NPI: 1225011562
Provider Name (Legal Business Name): PUSHPA CHAUHAN D.P.M.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W 86TH ST MS#2
NEW YORK NY
10024-4018
US

IV. Provider business mailing address

160 W 86TH ST MS#2
NEW YORK NY
10024-4018
US

V. Phone/Fax

Practice location:
  • Phone: 212-362-7322
  • Fax: 212-362-7084
Mailing address:
  • Phone: 212-362-7322
  • Fax: 212-362-7084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004370-1
License Number StateNY

VIII. Authorized Official

Name: DR. PUSHPA CHAUHAN
Title or Position: PODIATRIST
Credential: D.P.M.
Phone: 212-362-7322