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General NPI Number Information
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NPI Number | 1255421418
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Entity Type | Organization
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Legal Business Name | AZIZ CHAUDRY
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2B MEDICAL PARK DRIVE
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776
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Country | US
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Telephone | 631-928-1830
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Fax | 631-928-1830
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Provider Business Mailing Address
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Address Line | 2B MEDICAL PARK DRIVE
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776
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Country | US
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Telephone | 631-928-1830
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Fax | 631-928-1830
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AZIZ CHAUDRY
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Credential | MD
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Telephone | 631-928-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 123041
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License Number State | NY
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