Provider Demographics
NPI:1083617617
Name:CHEEMA, AYESHA (MD)
Entity Type:Individual
Prefix:DR
First Name:AYESHA
Middle Name:
Last Name:CHEEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WEST BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477
Mailing Address - Country:US
Mailing Address - Phone:845-246-3000
Mailing Address - Fax:845-246-7622
Practice Address - Street 1:368 BROADWAY
Practice Address - Street 2:SUITE 402
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5144
Practice Address - Country:US
Practice Address - Phone:845-334-4336
Practice Address - Fax:845-334-2746
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218659207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02254608Medicaid
206258OtherWELLCARE
66617OtherGHI HMO
NY283336OtherMVP
460003602OtherRAILROAD MEDICARE
NY10063817OtherCDPHP
AC0073AN10OtherEMPIRE BLUE CROSS
NYH61743Medicare UPIN
NY283336OtherMVP
460003602OtherRAILROAD MEDICARE