Provider Demographics
NPI:1992798003
Name:CHAUDHRY, RIAZ A (MD)
Entity type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:A
Last Name:CHAUDHRY
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 1:5159 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1414
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:12550-1414
Practice Address - Country:US
Practice Address - Phone:845-565-7800
Practice Address - Fax:845-565-6565
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186291207RP1001X, 207R00000X, 225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01439665Medicaid
110077255OtherPALMETTO/GBA RAILROAD MED
NY01439665Medicaid
02H361Medicare PIN