1184725343 NPI number — SHALOO CHOUDHARY OTR

Table of content: SHALOO CHOUDHARY OTR (NPI 1184725343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184725343 NPI number — SHALOO CHOUDHARY OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOUDHARY
Provider First Name:
SHALOO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
UPPAL
Provider Other First Name:
SHALOO
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1184725343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1081 ROUTE 22
Provider Second Line Business Mailing Address:
SOMERSET ORTHOPEDICS ASSOCIATES PA
Provider Business Mailing Address City Name:
BRIDGEWATER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08807-2921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-252-9700
Provider Business Mailing Address Fax Number:
908-252-0707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1081 ROUTE 22
Provider Second Line Business Practice Location Address:
SOMERSET ORTHOPEDICS ASSOCIATES PA
Provider Business Practice Location Address City Name:
BRIDGEWATER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08807-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-252-9700
Provider Business Practice Location Address Fax Number:
908-252-0707
Provider Enumeration Date:
09/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  46TR00134200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)