Provider Demographics
NPI:1578597142
Name:CHAUDHRY, SAULAT S (MD)
Entity Type:Individual
Prefix:
First Name:SAULAT
Middle Name:S
Last Name:CHAUDHRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:630 W 168TH ST # 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-9817
Mailing Address - Fax:914-327-2183
Practice Address - Street 1:1086 N BROADWAY STE 240
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1115
Practice Address - Country:US
Practice Address - Phone:914-377-0300
Practice Address - Fax:914-327-2183
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196885207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
060037223OtherRAILROAD MEDICARE
WS1356OtherOXFORD
0D0213OtherACS HEALTHNET
NY01906569Medicaid
NY42J291OtherBCBS
NY42J291Medicare PIN
0D0213OtherACS HEALTHNET