Provider Demographics
NPI:1669647939
Name:ABDUL R CHAUDHRY INTERNAL MEDICINE PC
Entity Type:Organization
Organization Name:ABDUL R CHAUDHRY INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PC
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHAUDHRY INTERNAL MEDICINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-786-3188
Mailing Address - Street 1:326 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-9339
Mailing Address - Country:US
Mailing Address - Phone:585-786-3188
Mailing Address - Fax:585-786-2013
Practice Address - Street 1:326 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-9339
Practice Address - Country:US
Practice Address - Phone:585-786-3188
Practice Address - Fax:585-786-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137074207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B71725Medicare UPIN
A87831Medicare PIN