Provider Demographics
NPI:1033119573
Name:CHAUDHRY, MOHAMMAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:A
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 32ND ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2434
Mailing Address - Country:US
Mailing Address - Phone:201-758-7250
Mailing Address - Fax:201-758-7251
Practice Address - Street 1:570 32ND ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2434
Practice Address - Country:US
Practice Address - Phone:201-758-7250
Practice Address - Fax:201-758-7251
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07811600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ425AL1OtherEMPIRE BC UNION CITY
NJ0071994Medicaid
NJ2K8676OtherHEALTHNET
NJ3745405OtherAETNA HMO ID #
NJP00405000OtherRAILROAD MEDICARE
NJ7072691OtherAETNA PPO ID #
NJ2590032OtherGHI
NJP3548017OtherOXFORD
NJ425AL2OtherEMPIRE BC ENGLEWOOD
NJP00405000OtherRAILROAD MEDICARE
NJ0071994Medicaid
NJ2590032OtherGHI