Provider Demographics
NPI:1285737650
Name:CHAWLA, KATE KASTURI (MD, FACOG)
Entity type:Individual
Prefix:MRS
First Name:KATE
Middle Name:KASTURI
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207-19 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1732
Mailing Address - Country:US
Mailing Address - Phone:718-217-0800
Mailing Address - Fax:718-217-0823
Practice Address - Street 1:207-19 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1732
Practice Address - Country:US
Practice Address - Phone:718-217-0800
Practice Address - Fax:718-217-0823
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115020207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00211032Medicaid
C11398Medicare UPIN
NY00211032Medicaid