Choudhury, Sourab

Choudhury, Sourab is an individual health care provider with primary practice located at 161 Atlantic Ave Suite 202, Brooklyn NY 11201-6720. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Pediatric Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Choudhury, Sourab can be contacted via phone (718) 797-5504.

Contact Information

Primary practice address
161 Atlantic Ave Suite 202 Brooklyn NY 11201-6720
Phone: (718) 797-5504
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 226018 New York
Allopathic & Osteopathic Physicians / Pediatric Dermatology 207NP0225X 226018 New York

Profile Details

NPI number 1861453698
LBN Legal business name Choudhury, Sourab
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Dec 17th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861453698 NPPES
New York MEDICAID 02358652

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