Provider Demographics
NPI:1851353908
Name:CHAUDHRY, ABDUL REHMAN (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:REHMAN
Last Name:CHAUDHRY
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 1:326 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:585-186-2013
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137074207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00747457Medicaid
NY00747457Medicaid
NYB71725Medicare UPIN