Provider Demographics
NPI:1659104792
Name:SHAHRIAR, CHOWDHURY (MD)
Entity type:Individual
Prefix:
First Name:CHOWDHURY
Middle Name:
Last Name:SHAHRIAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 60TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2534
Mailing Address - Country:US
Mailing Address - Phone:929-471-6188
Mailing Address - Fax:
Practice Address - Street 1:11915 27TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-1011
Practice Address - Country:US
Practice Address - Phone:718-461-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-P130408-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine