Provider Demographics
NPI:1003059981
Name:AHMED, LOTUS (DO)
Entity Type:Individual
Prefix:
First Name:LOTUS
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5289
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5289
Mailing Address - Country:US
Mailing Address - Phone:718-670-1415
Mailing Address - Fax:516-437-4167
Practice Address - Street 1:518 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3870
Practice Address - Country:US
Practice Address - Phone:917-848-5432
Practice Address - Fax:347-252-6754
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264355207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG4100080546Medicare PIN