Provider Demographics
NPI:1962063255
Name:CHOWDUARY, MAHIDUL (MD)
Entity type:Individual
Prefix:
First Name:MAHIDUL
Middle Name:
Last Name:CHOWDUARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 FULTON AVE STE 12A
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3648
Mailing Address - Country:US
Mailing Address - Phone:718-212-0000
Mailing Address - Fax:929-822-7518
Practice Address - Street 1:1 FULTON AVE STE 12A
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3648
Practice Address - Country:US
Practice Address - Phone:718-212-0000
Practice Address - Fax:929-822-7518
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY31866701207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine