Healthcare Provider Details

I. General information

NPI: 1326294471
Provider Name (Legal Business Name): AISHA S CHAUDHRY DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 KLOCKNER RD
HAMILTON NJ
08619-2711
US

IV. Provider business mailing address

3046 KNIGHTS RD
BENSALEM PA
19020-2815
US

V. Phone/Fax

Practice location:
  • Phone: 609-586-6700
  • Fax: 609-586-8768
Mailing address:
  • Phone: 215-639-4500
  • Fax: 215-604-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006158
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00297700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: