Provider Demographics
NPI:1538266168
Name:CHOUDHURY, ASM JUNNUN (MD)
Entity type:Individual
Prefix:DR
First Name:ASM
Middle Name:JUNNUN
Last Name:CHOUDHURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8732 167TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3636
Mailing Address - Country:US
Mailing Address - Phone:718-739-3145
Mailing Address - Fax:718-558-8527
Practice Address - Street 1:8268 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1121
Practice Address - Country:US
Practice Address - Phone:718-883-2971
Practice Address - Fax:718-883-6167
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2187672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY0033S231Medicare ID - Type Unspecified