Provider Demographics
NPI:1902003635
Name:CHAUDHRY, ABID HUSSAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABID
Middle Name:HUSSAIN
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 1:1138 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-1032
Mailing Address - Country:US
Mailing Address - Phone:917-626-6222
Mailing Address - Fax:
Practice Address - Street 1:1855 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-4705
Practice Address - Country:US
Practice Address - Phone:305-242-8025
Practice Address - Fax:305-397-2669
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100581207Q00000X, 207R00000X, 207P00000X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280246500Medicaid