Provider Demographics
NPI:1457093148
Name:AHMAD, IFTIKHAR (PT)
Entity Type:Individual
Prefix:
First Name:IFTIKHAR
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 DUBLIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-1022
Mailing Address - Country:US
Mailing Address - Phone:504-861-4693
Mailing Address - Fax:504-865-8379
Practice Address - Street 1:714 DUBLIN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1022
Practice Address - Country:US
Practice Address - Phone:504-861-4693
Practice Address - Fax:504-865-8379
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11141F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist