Provider Demographics
NPI:1306019617
Name:NASAR A CHAUDHRY, PHYSICIAN, PLLC
Entity type:Organization
Organization Name:NASAR A CHAUDHRY, PHYSICIAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NASAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIAN, PLLC
Authorized Official - Phone:607-324-5031
Mailing Address - Street 1:327 SENECA RD
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1033
Mailing Address - Country:US
Mailing Address - Phone:607-324-5031
Mailing Address - Fax:607-324-0585
Practice Address - Street 1:327 SENECA RD
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1033
Practice Address - Country:US
Practice Address - Phone:607-324-5031
Practice Address - Fax:607-324-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116917209800000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No209800000XAllopathic & Osteopathic PhysiciansLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00459114Medicaid
B81823Medicare UPIN
BA0650Medicare PIN
NY00459114Medicaid
NYBA0650Medicare PIN