Provider Demographics
NPI:1457447849
Name:CHAUDHURI, PRADIPTA (MD)
Entity Type:Individual
Prefix:
First Name:PRADIPTA
Middle Name:
Last Name:CHAUDHURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:3131 LA CANADA ST STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2579
Practice Address - Country:US
Practice Address - Phone:702-216-3346
Practice Address - Fax:702-671-6883
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20761207RC0000X
OH35.067034207RC0000X
NV17733207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0537795Medicaid
NE10026072400Medicaid
NE47070592302Medicaid
NE47070592306Medicaid
NV1043533383Medicaid
KS100412940BMedicaid
NE10026072500Medicaid
NE47070592305Medicaid
NE47070592313Medicaid
NE47070592300Medicaid
NE47070592301Medicaid
NE47070592302Medicaid
NE271020Medicare PIN
NE10026072400Medicaid
NE47070592305Medicaid
NE47070592300Medicaid