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General NPI Number Information
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NPI Number | 1669651121
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Entity Type | Organization
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Legal Business Name | PUTNAM CARDIO PULMONARY SERVICES, P.C.
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 112 CLOCK TOWER COMMONS BLDG 1
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City | BREWSTER
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State | NY
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Zip | 10509-4055
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Country | US
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Telephone | 845-279-2209
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Fax |
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Provider Business Mailing Address
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Address Line | 112 CLOCK TOWER COMMONS BLDG 1
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City | BREWSTER
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State | NY
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Zip | 10509-4055
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Country | US
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Telephone | 845-279-2209
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MADDIPOTI J CHOUDRY
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Credential | M.D.
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Telephone | 845-279-2209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 129945
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License Number State | NY
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