| Chowdhury Medical Care Pc | |
|
1084 Liberty Ave Brooklyn NY 11208-2923 | |
| (718) 277-2700 | |
| (718) 277-4191 |
| Full Name | Chowdhury Medical Care Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1084 Liberty Ave, Brooklyn, New York |
| Authorized Official Name and Position | Asm Shah Alam Chowdhury (M.D) |
| Authorized Official Contact | 7182772700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chowdhury Medical Care Pc 1084 Liberty Ave Brooklyn NY 11208-2923 Ph: (718) 277-2700 | Chowdhury Medical Care Pc 1084 Liberty Ave Brooklyn NY 11208-2923 Ph: (718) 277-2700 |
| NPI Number | 1467822882 |
|---|---|
| Provider Enumeration Date | 09/28/2015 |
| Last Update Date | 09/28/2015 |
| Medicare PECOS PAC ID | 6800189184 |
|---|---|
| Medicare Enrollment ID | O20160725000861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467822882 | NPI | - | NPPES |
| 211248 | Other | NY | NY STATE LICENSE |
| 607526764 | Other | NY | TAX I'D |
| 025993699 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | A S M Shah Alam Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356418511 PECOS PAC ID: 5597725234 Enrollment ID: I20041016000003 |
| Provider Name | Elizabeth Nosier-turenne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841701711 PECOS PAC ID: 6709148000 Enrollment ID: I20180327000766 |
| Provider Name | Lucrece Bonostro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205320769 PECOS PAC ID: 3678824646 Enrollment ID: I20181002000390 |
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