Basic Information
| Provider Information | |||||||||
| NPI: | 1578597142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAUDHRY | ||||||||
| FirstName: | SAULAT | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 W 168TH ST # 4 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100323725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123059817 | ||||||||
| FaxNumber: | 9143272183 | ||||||||
| Practice Location | |||||||||
| Address1: | 1086 N BROADWAY STE 240 | ||||||||
| Address2: | |||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107011115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143770300 | ||||||||
| FaxNumber: | 9143272183 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 05/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 196885 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 196885 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 060037223 | 01 | RAILROAD MEDICARE | OTHER | WS1356 | 01 | OXFORD | OTHER | 0D0213 | 01 | ACS HEALTHNET | OTHER | 01906569 | 05 | NY | MEDICAID | 42J291 | 01 | NY | BCBS | OTHER |