1710942644 NPI number — DR. GOVIND PRAKASH CHATURVEDI M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710942644 NPI number — DR. GOVIND PRAKASH CHATURVEDI M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CHATURVEDI

Provider First Name:

GOVIND

Provider Middle Name:

PRAKASH

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1710942644

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/22/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

33 GRAND ST STE 39B

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

KINGSTON

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

12401-3933

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

845-331-4282

Provider Business Mailing Address Fax Number:

845-331-4380

Provider First Line Business Practice Location Address:

33 GRAND ST STE 39B

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

KINGSTON

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

12401-3933

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

845-331-4282

Provider Business Practice Location Address Fax Number:

845-331-4380

Provider Enumeration Date:

04/20/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Y00000X , with the licence number:  159759 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 103446 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 00941460 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 047112 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 59D261 . This is a "MATRIX" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 805571 . This is a "METLIFE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 10032289 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 80123000001595 . This is a "B/S OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: PM6284 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 000000003446 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0068864 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 159759-0 . This is a "WORKMANS COMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".