MEDICARE: JAYANTA CHAUDHURI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	256566	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497716492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYANTA CHAUDHURI MD

Provider Business Mailing Address
First Line	:	4525 WITMER RD
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14305-1341
Country	:	US
Telephone Number	:	716-298-0230
Fax Number	:	716-298-0233

Provider Business Practice Location Address
First Line	:	4525 WITMER RD
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14305-1341
Country	:	US
Telephone Number	:	716-298-0230
Fax Number	:	716-298-0233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	05/21/2026

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