Basic Information
| Provider Information | |||||||||
| NPI: | 1386023067 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAUDHURY | ||||||||
| FirstName: | ANKUR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 REECEVILLE RD | ||||||||
| Address2: | |||||||||
| City: | COATESVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193201542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157627916 | ||||||||
| FaxNumber: | 2157627765 | ||||||||
| Practice Location | |||||||||
| Address1: | 245 N 15TH ST, 6TH FLOOR | ||||||||
| Address2: | DREXEL UNIVERSITY COLLEGE OF MEDICINE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157627916 | ||||||||
| FaxNumber: | 2157627765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2015 | ||||||||
| LastUpdateDate: | 10/22/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD465361 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.