Healthcare Provider Details

I. General information

NPI: 1053617712
Provider Name (Legal Business Name): CHOPRA PHYSICIAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25A BARNUM AVE
PLAINVIEW NY
11803-6005
US

IV. Provider business mailing address

25A BARNUM AVE
PLAINVIEW NY
11803-6005
US

V. Phone/Fax

Practice location:
  • Phone: 516-605-1030
  • Fax:
Mailing address:
  • Phone: 516-605-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number247381
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number247381
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number247381
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SACHIN CHOPRA
Title or Position: PRESIDENT
Credential: D.O.
Phone: 516-603-2174