Provider Demographics
NPI:1336151620
Name:CHAWLA, DINESH K (MD)
Entity type:Individual
Prefix:DR
First Name:DINESH
Middle Name:K
Last Name:CHAWLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1992 CLINTON AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5620
Mailing Address - Country:US
Mailing Address - Phone:585-442-2020
Mailing Address - Fax:585-442-2022
Practice Address - Street 1:1992 CLINTON AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5620
Practice Address - Country:US
Practice Address - Phone:585-442-2020
Practice Address - Fax:585-442-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140887207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5793319OtherAETNA
NY0780OtherBLUE CROSS/BLUE SHIELD
NY00631174Medicaid
NY100886CROtherPREFERRED CARE
NY00631174Medicaid