Provider Demographics
NPI:1417921297
Name:CHOWDHARY, VAIDEHI R (MD)
Entity type:Individual
Prefix:
First Name:VAIDEHI
Middle Name:R
Last Name:CHOWDHARY
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 1:300 CEDAR STREET, RM. S-517 TAC
Mailing Address - Street 2:SECTION OF RHEUMATOLOGY, YALE UNIV SCHOOL OF MEDICINE
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519
Mailing Address - Country:US
Mailing Address - Phone:203-785-2454
Mailing Address - Fax:
Practice Address - Street 1:6 DEVINE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473
Practice Address - Country:US
Practice Address - Phone:203-785-2454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT63563207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN051683000Medicaid
MNP00425222OtherRAILROAD MEDICARE
CT63563OtherCT DEPARTMENT OF PUBLIC HEALTH
I48107Medicare UPIN
MN660000201Medicare PIN