Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MB08701400 | NJ |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | OS014059 | PA |
NPI | 1063656882 |
---|---|
Provider Name | Dr. Farhad Reza Chowdhury |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Old Bridge, NJ 08857-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 01/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25MB08701400 | LICENSE (01) | NJ |
P00938037 | RAILROAD MEDICARE PIN (01) | NJ |