Provider Demographics
NPI:1205916038
Name:CHAMUDES, OSCAR (MD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:CHAMUDES
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 1:31-87 STEINWAY ST SUITE#6
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3952
Mailing Address - Country:US
Mailing Address - Phone:718-626-4881
Mailing Address - Fax:718-626-5102
Practice Address - Street 1:3187 STEINWAY ST STE 6
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3952
Practice Address - Country:US
Practice Address - Phone:718-626-4881
Practice Address - Fax:718-626-5102
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135195-12080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00298980Medicaid