Provider Demographics
NPI:1235540642
Name:AHMED, AMANI A (MBBS, MS)
Entity Type:Individual
Prefix:
First Name:AMANI
Middle Name:A
Last Name:AHMED
Suffix:
Gender:F
Credentials:MBBS, MS
Other - Prefix:
Other - First Name:AMANI
Other - Middle Name:AHMED
Other - Last Name:AL-TAROUTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS, MS
Mailing Address - Street 1:243 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:243 CHARLES ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3002
Practice Address - Country:US
Practice Address - Phone:312-532-7672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278313208D00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology