Provider Demographics
NPI:1972508448
Name:CHUGHTAI, ZENAIDA ALDERETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:ZENAIDA
Middle Name:ALDERETTE
Last Name:CHUGHTAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 WEST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641
Mailing Address - Country:US
Mailing Address - Phone:330-875-1454
Mailing Address - Fax:330-875-8680
Practice Address - Street 1:3030 WEST TUSCARAWAS ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708
Practice Address - Country:US
Practice Address - Phone:330-452-2334
Practice Address - Fax:330-452-6814
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036690208000000X
OH036690208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0283090Medicaid