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Contact Information

SOURAB CHOUDHURY, DO
161 ATLANTIC AVE
SUITE 202
BROOKLYN, NY11201-6720
 Phone: 718-797-5504
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Pediatric Dermatology

207NP0225X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for SOURAB CHOUDHURY · (Male)

NPI Number 1861453698
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/31/2006
Last updated 12/17/2007 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 226018
  • NY Medicaid 02358652
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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