Provider Demographics
NPI:1841815859
Name:CHUGHTAI, TAUSIF A (MD)
Entity type:Individual
Prefix:
First Name:TAUSIF
Middle Name:A
Last Name:CHUGHTAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MOONACHIE
Mailing Address - State:NJ
Mailing Address - Zip Code:07074-1513
Mailing Address - Country:US
Mailing Address - Phone:917-250-3032
Mailing Address - Fax:
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7606
Practice Address - Country:US
Practice Address - Phone:718-590-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12002000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine