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General NPI Number Information
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NPI Number | 1487196622
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Entity Type | Organization
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Legal Business Name | NORTHERN MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 129 CLOVE BRANCH RD
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City | HOPEWELL JCT
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State | NY
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Zip | 12533-5284
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Country | US
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Telephone | 845-592-4915
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Fax | 557-037-5708
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Provider Business Mailing Address
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Address Line | 159 BARNEGAT RD
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601-5454
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Country | US
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Telephone | 845-592-4915
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Fax | 845-592-4914
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Authorized Official
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Title or Position | PRESIDENT
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Name | MADDIPOTI CHOUDRY
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Credential | MD
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Telephone | 845-592-4915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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