Provider Demographics
NPI:1235246588
Name:CHOUDRY, ABAID ULLAH ANWAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ABAID ULLAH
Middle Name:ANWAR
Last Name:CHOUDRY
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 1:2775 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5515
Mailing Address - Country:US
Mailing Address - Phone:201-222-7899
Mailing Address - Fax:201-222-7801
Practice Address - Street 1:2775 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5515
Practice Address - Country:US
Practice Address - Phone:201-222-7899
Practice Address - Fax:201-222-7801
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA71675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8632308Medicaid
054896Medicare ID - Type Unspecified
NJ8632308Medicaid