Basic Information
Provider Information
NPI: 1679913164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAUDRY
FirstName: ASIM
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 PARK STREET
Address2: GLENS FALLS HOSPITAL - CREDENTIALING
City: GLENS FALLS
State: NY
PostalCode: 128014413
CountryCode: US
TelephoneNumber: 5189266992
FaxNumber: 5189266983
Practice Location
Address1: 100 PARK ST
Address2: GLENS FALLS HOSPITAL - HOSPITALIST PROGRAM
City: GLENS FALLS
State: NY
PostalCode: 128014413
CountryCode: US
TelephoneNumber: 5189265925
FaxNumber: 5189265917
Other Information
ProviderEnumerationDate: 06/28/2013
LastUpdateDate: 05/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X285096NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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