Provider Demographics
NPI:1992895015
Name:CHOLST, INA N (MD)
Entity type:Individual
Prefix:
First Name:INA
Middle Name:N
Last Name:CHOLST
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 1:1305 YORK AVE
Mailing Address - Street 2:SUITE 721
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5663
Mailing Address - Country:US
Mailing Address - Phone:646-962-3025
Mailing Address - Fax:212-746-3511
Practice Address - Street 1:1305 YORK AVE
Practice Address - Street 2:SUITE 721
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5663
Practice Address - Country:US
Practice Address - Phone:646-962-3025
Practice Address - Fax:212-746-3511
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146313207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY62A411Medicare ID - Type UnspecifiedMEDICARE
NYB17143Medicare UPIN