Provider Demographics
NPI:1447261276
Name:CHAUDHARY, YASMEEN (MD)
Entity type:Individual
Prefix:
First Name:YASMEEN
Middle Name:
Last Name:CHAUDHARY
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 1:400 FAWNS RUN
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4400
Mailing Address - Country:US
Mailing Address - Phone:732-526-7451
Mailing Address - Fax:
Practice Address - Street 1:398 AVENUE E
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4638
Practice Address - Country:US
Practice Address - Phone:201-455-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07439600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0104655Medicaid
087961OtherMEDICARE PTAN
NJ0104655Medicaid