1417921297 NPI number — VAIDEHI R CHOWDHARY M.D.

Table of content: VAIDEHI R CHOWDHARY M.D. (NPI 1417921297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417921297 NPI number — VAIDEHI R CHOWDHARY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOWDHARY
Provider First Name:
VAIDEHI
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417921297
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 CEDAR STREET, RM. S-517 TAC
Provider Second Line Business Mailing Address:
SECTION OF RHEUMATOLOGY, YALE UNIV SCHOOL OF MEDICINE
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-785-2454
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 DEVINE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-785-2454
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/16/2006

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: 207RR0500X , with the licence number:  63563 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 051683000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00425222 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 63563 . This is a "CT DEPARTMENT OF PUBLIC HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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