Healthcare Provider Details

I. General information

NPI: 1821418484
Provider Name (Legal Business Name): CHANDAN KHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 READE PL
POUGHKEEPSIE NY
12601
US

IV. Provider business mailing address

1351 ROUTE 55 STE 200
LAGRANGEVILLE NY
12540-5128
US

V. Phone/Fax

Practice location:
  • Phone: 845-345-4485
  • Fax:
Mailing address:
  • Phone: 845-475-9661
  • Fax: 845-475-9938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number289971
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number288971
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: