Provider Demographics
NPI:1235106949
Name:AHMED, ANSAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANSAR
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 1:43 BATAVIA CITY CTR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2146
Mailing Address - Country:US
Mailing Address - Phone:585-343-7117
Mailing Address - Fax:585-343-3783
Practice Address - Street 1:43 BATAVIA CITY CTR
Practice Address - Street 2:SUITE A
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2146
Practice Address - Country:US
Practice Address - Phone:585-343-7117
Practice Address - Fax:585-343-3783
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1234832080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP01023483OtherBLUE CHOICE
NY00468171Medicaid
NY1201232OtherINDEPENDENT HEALTH
NY000506583004OtherBLUE CROSS OF WNY
NY100716DLOtherPREFERRED CARE