Provider Demographics
NPI:1326294471
Name:CHAUDHRY, AISHA S (DPM)
Entity Type:Individual
Prefix:MRS
First Name:AISHA
Middle Name:S
Last Name:CHAUDHRY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2815
Mailing Address - Country:US
Mailing Address - Phone:215-639-4500
Mailing Address - Fax:215-604-0355
Practice Address - Street 1:1725 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2711
Practice Address - Country:US
Practice Address - Phone:609-586-6700
Practice Address - Fax:609-586-8768
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006158213ES0103X
NJ25MD00297700213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102420123-0002Medicaid
PA1024201230001Medicaid
CH2135012OtherHIGHMARK BLUE SHIELD
CH2135012OtherHIGHMARK BLUE SHIELD
NJ130656ZAKEMedicare PIN
PA6148500003Medicare NSC
NJ130657Medicare PIN