Provider Demographics
NPI:1871530295
Name:CHAUDHARI, JENNIFER E (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:CHAUDHARI
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 1:160 S RIVER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6927
Mailing Address - Country:US
Mailing Address - Phone:603-647-0494
Mailing Address - Fax:603-647-0493
Practice Address - Street 1:160 S RIVER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6927
Practice Address - Country:US
Practice Address - Phone:603-647-0494
Practice Address - Fax:603-647-0493
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30205522Medicaid
NH30205522Medicaid
NHRE8477Medicare ID - Type Unspecified