Provider Demographics
NPI:1083659239
Name:AHMED, ZIA
Entity Type:Individual
Prefix:DR
First Name:ZIA
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 73RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1903
Mailing Address - Country:US
Mailing Address - Phone:718-469-6600
Mailing Address - Fax:718-856-0714
Practice Address - Street 1:608 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1839
Practice Address - Country:US
Practice Address - Phone:347-985-1021
Practice Address - Fax:718-484-9000
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01566976Medicaid
NY01566976Medicaid
NY02J291Medicare ID - Type Unspecified