1699863290 NPI number — KAUSAR CHAUDHRY MD

Table of content: KAUSAR CHAUDHRY MD (NPI 1699863290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699863290 NPI number — KAUSAR CHAUDHRY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAUDHRY
Provider First Name:
KAUSAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699863290
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7513 COURT STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELIZABETHTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12932-0008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-873-3670
Provider Business Mailing Address Fax Number:
518-873-3777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7513 COURT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-873-3670
Provider Business Practice Location Address Fax Number:
518-873-3777
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  23566801 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 384124 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7803777 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000415477001 . This is a "BS OF NENY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00565040 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02659070 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13898 . This is a "BS OF NENY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 148543 . This is a "VALUE OPTION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3189393 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 114406 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: W9791 . This is a "EMPIRE BC BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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