Provider Demographics
NPI:1376659037
Name:CHAUDHARY, AYESHA (MD)
Entity Type:Individual
Prefix:
First Name:AYESHA
Middle Name:
Last Name:CHAUDHARY
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 1:4 COZY DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8836
Mailing Address - Country:US
Mailing Address - Phone:322-773-3811
Mailing Address - Fax:732-845-4579
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:324-310-0237
Practice Address - Fax:732-431-5023
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07801100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0051616Medicaid
NJ0051616Medicaid
I20878Medicare UPIN
NJI20878Medicare UPIN
NJ085258Medicare PIN
NJ085258M5NMedicare PIN