Provider Demographics
NPI:1396828109
Name:CHOUDRY, MUHAMMAD ABU-BAKR (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:ABU-BAKR
Last Name:CHOUDRY
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 1:322 SIP AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-6525
Mailing Address - Country:US
Mailing Address - Phone:201-332-2933
Mailing Address - Fax:
Practice Address - Street 1:2787 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5531
Practice Address - Country:US
Practice Address - Phone:201-659-0311
Practice Address - Fax:201-659-0311
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08079800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine