Provider Demographics
NPI:1184691065
Name:CHAUDHRI, KAMRAN I (MD)
Entity type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:I
Last Name:CHAUDHRI
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 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-547-3456
Mailing Address - Fax:
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222888207W00000X
NY219404207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherONE HEALTH PLAN
042472266OtherTHREE RIVERS
409550OtherTUFTS HEALTH PLAN
4346949OtherCIGNA HEALTH PLAN
MA2085101Medicaid
7535289OtherAETNA US HEALTHCARE
784008OtherMVP HEALTH CARE
0801399OtherEVERCARE
76103OtherHEALTHY START
J28225OtherBLUE CARE ELECT
J28225OtherBLUE SHIELD INDEMNITY
042472266OtherHEALTHCARE VALUE
90589OtherFALLON COMMUNITY HEALTH
AA19861OtherHARVARD PILGRIM
042472266OtherPRIVATE HEALTHCARE SYSTEM
76103OtherCHILDRENS MEDICAL SECURIT
J28225OtherBLUE SHIELD HMO BLUE
042472266OtherONE HEALTH PLAN
J28225OtherBLUE SHIELD INDEMNITY
J28225OtherBLUE CARE ELECT
042472266OtherTHREE RIVERS