Provider Demographics
NPI:1982624482
Name:CHAUDARI, TARIQ A (RPH)
Entity Type:Individual
Prefix:MR
First Name:TARIQ
Middle Name:A
Last Name:CHAUDARI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9333
Mailing Address - Country:US
Mailing Address - Phone:585-473-2555
Mailing Address - Fax:585-242-7580
Practice Address - Street 1:750 EAST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2100
Practice Address - Country:US
Practice Address - Phone:585-473-2555
Practice Address - Fax:585-242-7580
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist