Provider Demographics
NPI:1386317402
Name:CHAUDARY, NABEEL FUROOQ (OD)
Entity type:Individual
Prefix:MR
First Name:NABEEL
Middle Name:FUROOQ
Last Name:CHAUDARY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E 19TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2130
Mailing Address - Country:US
Mailing Address - Phone:908-752-3595
Mailing Address - Fax:
Practice Address - Street 1:805 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4310
Practice Address - Country:US
Practice Address - Phone:718-851-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-10-14
Deactivation Date:2021-09-09
Deactivation Code:
Reactivation Date:2021-10-05
Provider Licenses
StateLicense IDTaxonomies
NY009462152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist