Individual
PREMENDRA CHAUDHARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-1379
Mailing address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-1379
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
04/07/2014
Last updated
09/18/2018
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