Provider Demographics
NPI:1427075894
Name:CHOUNZOM, TENZING (MD)
Entity type:Individual
Prefix:
First Name:TENZING
Middle Name:
Last Name:CHOUNZOM
Suffix:
Gender:F
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:PO BOX 746087
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6087
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:9701 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11368-1043
Practice Address - Country:US
Practice Address - Phone:718-765-6053
Practice Address - Fax:347-706-3810
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD30295207R00000X
NY306975207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00221580OtherMEIDCARE RAILROAD NUMBER
TN3838203Medicaid
TN4097056OtherBLUE CROSS NUMBER
TNTN0106OtherJOHNDEERE NUMBER
TNP00221580OtherMEIDCARE RAILROAD NUMBER
TN3838203Medicaid