Provider Demographics
NPI:1962813048
Name:IRUM CHAUDHRY MEDICAL P.C
Entity Type:Organization
Organization Name:IRUM CHAUDHRY MEDICAL P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRUM
Authorized Official - Middle Name:ANWAR
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-505-0085
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:446 EAST MEADOW AVE
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-0148
Mailing Address - Country:US
Mailing Address - Phone:516-505-0085
Mailing Address - Fax:516-505-0112
Practice Address - Street 1:380 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2701
Practice Address - Country:US
Practice Address - Phone:516-505-0085
Practice Address - Fax:516-505-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260565207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty