Abida Chaudhary
Individual provider Active NPI Family Nurse Practitioner · Vernon, CT
NPI 1962213124 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1962213124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 14350 (CT)
- Practice address
- 145 Union St
Vernon, CT 06066-3025 - Phone
- (860) 375-8440
- NPI assigned
- Jan 16, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250326000099 | CT | Practitioner - Nurse Practitioner | 9335662865 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14350 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Dialog Healthcare, LLC | Current |
Accepting new patients |
Locations
175 Capital Blvd
Fl 4
Rocky Hill, CT 06067
Phone (860) 380-0452
1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443
50 Chestnut Ridge Rd
Ste 130
Montvale, NJ 07645
Phone (845) 213-3134
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14350 | CT | Yes |
Addresses
Primary practice location
145 Union St
Vernon, CT 06066-3025
Mailing address
145 Union St
Vernon, CT 06066-3025
Phone (860) 375-8440
Other providers in Vernon, CT
- Eleas J Chafouleas
- Mayank Chaliawala
- Chandra K. Sacheti, M.D., LLC
- Chandra Sacheti, MD, LLC
- Shaylyn Charbonneau
- Shahida Chaudhary
- Rubbab Chaudhry
- Anshu Chen
- Sursatie Devi Chetram
- Katharine Fidelia Chicarello
All providers in Vernon, CT · Family Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.