Provider Demographics
NPI:1407001688
Name:CHAUDHARY, MUNEER AHMAD (PA)
Entity Type:Individual
Prefix:
First Name:MUNEER
Middle Name:AHMAD
Last Name:CHAUDHARY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 AVENUE Y
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2909
Mailing Address - Country:US
Mailing Address - Phone:718-615-4799
Mailing Address - Fax:
Practice Address - Street 1:2102 AVENUE Y
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2909
Practice Address - Country:US
Practice Address - Phone:718-615-4799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012624363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant