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General NPI Number Information
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NPI Number | 1013481357
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Entity Type | Organization
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Legal Business Name | 4 CHAUDHRYS LLC
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 01/21/2019
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Provider Practice Location Address
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Address Line | 2200 BURDETT AVE STE 103
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City | TROY
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State | NY
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Zip | 12180-2451
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Country | US
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Telephone | 518-331-8683
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Fax | 518-438-8601
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Provider Business Mailing Address
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Address Line | 2200 BURDETT AVE STE 103
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City | TROY
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State | NY
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Zip | 12180-2451
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Country | US
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Telephone | 518-331-8683
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Fax | 518-438-8601
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHAUDHRY M BILAL
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Credential |
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Telephone | 518-438-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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