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General NPI Number Information
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NPI Number | 1518139674
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Entity Type | Organization
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Legal Business Name | CHADHA PHYSICIAN PC
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 11203 QUEENS BLVD SUITE 201
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City | FOREST HILLS
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State | NY
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Zip | 11375-5550
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Country | US
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Telephone | 718-544-6660
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Fax | 718-544-6670
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Provider Business Mailing Address
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Address Line | 11203 QUEENS BLVD SUITE 201
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City | FOREST HILLS
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State | NY
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Zip | 11375-5550
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Country | US
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Telephone | 718-544-6660
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Fax | 718-544-6670
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANG B CHADHA
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Credential | M.D.
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Telephone | 718-544-6660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 149446
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 149446
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License Number State | NY
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