Healthcare Provider Details

I. General information

NPI: 1689695223
Provider Name (Legal Business Name): MUHAMMAD M CHOWDHURY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 FULLERTON AVE
NEWBURGH NY
12550-3726
US

IV. Provider business mailing address

327 FULLERTON AVE
NEWBURGH NY
12550-3726
US

V. Phone/Fax

Practice location:
  • Phone: 845-561-4032
  • Fax: 845-569-2411
Mailing address:
  • Phone: 845-561-4032
  • Fax: 845-569-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number192741
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number192741
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: