Provider Demographics
NPI:1124249024
Name:RIAZ A CHAUDHRY MD PC
Entity type:Organization
Organization Name:RIAZ A CHAUDHRY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RIAZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-565-7800
Mailing Address - Street 1:5159 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1452
Mailing Address - Country:US
Mailing Address - Phone:845-565-7800
Mailing Address - Fax:845-565-6565
Practice Address - Street 1:5159 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1452
Practice Address - Country:US
Practice Address - Phone:845-565-7800
Practice Address - Fax:845-565-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186291207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DG1519OtherPALMETTO/GBA RAILROAD MED