Provider Demographics
NPI:1316025562
Name:CHAUDHRY, SAQIB S (MD)
Entity Type:Individual
Prefix:
First Name:SAQIB
Middle Name:S
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:40 VALLEY STREAM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1407
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:610-644-8909
Practice Address - Street 1:1044 NORTHERN BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1514
Practice Address - Country:US
Practice Address - Phone:516-621-1313
Practice Address - Fax:516-621-0116
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1316662086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00479516Medicaid
NYC66973Medicare UPIN
NY00479516Medicaid