Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 309744 | NY |
NPI | 1013528595 |
---|---|
Provider Name | Mohammad Abraham Chaudry |
First Address | Hicksville, NY 11801-4440 |
Second Address | Hicksville, NY 11801-4440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2020 |
Last Update Date | 10/08/2020 |