Provider Demographics
NPI:1902981152
Name:ABOUCHEDID, CLAUDE (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:ABOUCHEDID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 KUSER RD
Mailing Address - Street 2:SUITE B3
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3829
Mailing Address - Country:US
Mailing Address - Phone:609-585-2323
Mailing Address - Fax:609-585-0625
Practice Address - Street 1:1542 KUSER RD
Practice Address - Street 2:SUITE B3
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3829
Practice Address - Country:US
Practice Address - Phone:609-585-2323
Practice Address - Fax:609-585-0625
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA25083208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF03153OtherHEALTHNET
NJ1039639OtherHORIZON MERCY
NJ0086193000OtherKEYSTONE HPE
NJ0730555000OtherAMERIHEALTH HMO
NJ166969OtherPABS
NJME212OtherOXFORD
NJ1436698OtherAETNA
NJ0086193000OtherAMERIHEALTH
NJ1739506Medicaid
NJ1739506Medicaid