Individual
TYIEBAH CHOUDHURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 PARK AVE, NEW YORK, NY 10016-5802
(212) 263-5020
Mailing address
419 E 12TH ST APT 1A, NEW YORK, NY 10009-4066
(917) 318-6750
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
F348333-01
NY
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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