Provider Demographics
NPI:1376614743
Name:CHAUDHRI, FARIDA P (MD)
Entity Type:Individual
Prefix:
First Name:FARIDA
Middle Name:P
Last Name:CHAUDHRI
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 1:14601 45TH
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-358-3057
Mailing Address - Fax:718-358-4045
Practice Address - Street 1:14601 45TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-358-3057
Practice Address - Fax:718-358-4045
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1473451207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00900990Medicaid
B14885Medicare UPIN
NY60009AMedicare ID - Type Unspecified