Provider Demographics
NPI:1164507323
Name:CLAUDE ABOUCHEDID,M.D., FACS, PA
Entity Type:Organization
Organization Name:CLAUDE ABOUCHEDID,M.D., FACS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUCHEDID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-585-2323
Mailing Address - Street 1:1542 KUSER RD
Mailing Address - Street 2:SUITE B3
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3829
Mailing Address - Country:US
Mailing Address - Phone:609-585-2323
Mailing Address - Fax:609-585-0625
Practice Address - Street 1:1542 KUSER RD
Practice Address - Street 2:SUITE B3
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3829
Practice Address - Country:US
Practice Address - Phone:609-585-2323
Practice Address - Fax:609-585-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0086193000OtherAMERIHEALTH
NJ106969OtherPA BLUE SHIELD
NJ3319601Medicaid
NJF03153OtherHEALTHNET
NJ0730555000OtherAMERIHEALTH HMO
NJ1436698OtherAETNA
NJ0086193000OtherKEYSTONE HPE
NJ1039639OtherHORIZON MERCY
NJ1436698OtherAETNA
NJ3319601Medicaid