Provider Demographics
NPI:1588696157
Name:CHAWLA, HARMINDER S (MD)
Entity type:Individual
Prefix:
First Name:HARMINDER
Middle Name:S
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 1:10 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1030
Mailing Address - Country:US
Mailing Address - Phone:201-487-7227
Mailing Address - Fax:
Practice Address - Street 1:10 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1030
Practice Address - Country:US
Practice Address - Phone:212-562-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190592207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01780625Medicaid
NY01780625Medicaid
NY56J452Medicare ID - Type Unspecified