Provider Demographics
NPI:1407184310
Name:AHMED, TAHIRA FASIHI (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHIRA
Middle Name:FASIHI
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TAHIRA
Other - Middle Name:GEERMAN
Other - Last Name:FASIHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-3220
Mailing Address - Fax:585-922-3518
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-3220
Practice Address - Fax:585-922-3518
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00745232085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program