Provider Demographics
NPI:1336184381
Name:CHAWLA, SANTPAL SINGH (FNP-C)
Entity type:Individual
Prefix:MR
First Name:SANTPAL
Middle Name:SINGH
Last Name:CHAWLA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 EDWARDS ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1121
Mailing Address - Country:US
Mailing Address - Phone:516-330-4215
Mailing Address - Fax:
Practice Address - Street 1:2343 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1212
Practice Address - Country:US
Practice Address - Phone:516-437-7236
Practice Address - Fax:516-437-7237
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ69057Medicare UPIN
NY1662G1Medicare ID - Type Unspecified