Basic Information
Provider Information
NPI: 1003963117
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOWDHURY
FirstName: NAZMUL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 333 CEDAR ST
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 065103206
CountryCode: US
TelephoneNumber: 2037852802
FaxNumber: 2037856664
Practice Location
Address1: 1450 CHAPEL ST # E2006
Address2:  
City: NEW HAVEN
State: CT
PostalCode: 065114405
CountryCode: US
TelephoneNumber: 2037893538
FaxNumber: 2038675461
Other Information
ProviderEnumerationDate: 01/04/2007
LastUpdateDate: 06/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X042307CTY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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