Provider Demographics
NPI:1366683757
Name:AHMAD, TAUQEER (MD)
Entity Type:Individual
Prefix:DR
First Name:TAUQEER
Middle Name:
Last Name:AHMAD
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 1:482 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3232
Mailing Address - Country:US
Mailing Address - Phone:718-987-5700
Mailing Address - Fax:718-987-1210
Practice Address - Street 1:482 MASON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3232
Practice Address - Country:US
Practice Address - Phone:718-987-7762
Practice Address - Fax:718-987-1210
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03112278Medicaid
NYA300001686Medicare PIN