Provider Demographics
NPI:1932587011
Name:MERCY SIDE OF CARE MEDICAL SERVICES PC
Entity type:Organization
Organization Name:MERCY SIDE OF CARE MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SYEDUR
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-200-0723
Mailing Address - Street 1:50 NORTH DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2255
Mailing Address - Country:US
Mailing Address - Phone:718-200-0723
Mailing Address - Fax:
Practice Address - Street 1:50 NORTH DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2255
Practice Address - Country:US
Practice Address - Phone:718-200-0723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty