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General NPI Number Information
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NPI Number | 1366884751
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Entity Type | Individual
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Provider Name | VICKY CHODHA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 2001 5TH AVE STE 110
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City | TROY
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State | NY
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Zip | 12180-3340
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Country | US
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Telephone | 518-687-1960
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Fax |
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Provider Business Mailing Address
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Address Line | 21025 35TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11361-1430
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 279397
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME 130556
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 279397
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License Number State | NY
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