Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 25MA06795400 | NJ |
N | 207RI0200X | Infectious Disease | MD-064889-L | PA |
NPI | 1083664460 |
---|---|
Provider Name | Mashiul Chowdhury |
First Address | Marlton, NJ 08053-4197 |
Second Address | Haddon Heights, NJ 08035-1938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 12/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01799383 | (05) | PA |
H14032 | (02) | PA |