Provider Demographics
NPI:1093778458
Name:AHMED, TAUSEEF (MD)
Entity Type:Individual
Prefix:
First Name:TAUSEEF
Middle Name:
Last Name:AHMED
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 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-493-8375
Mailing Address - Fax:914-347-1832
Practice Address - Street 1:19 BAKER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1359
Practice Address - Country:US
Practice Address - Phone:845-454-1942
Practice Address - Fax:845-452-4638
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142238207RH0000X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00787971Medicaid
NY00D421Medicare ID - Type Unspecified
NYC04418Medicare UPIN