Provider Demographics
NPI:1508249590
Name:AHSAN-UD-DIN, UNAVAILABLE (MD)
Entity Type:Individual
Prefix:DR
First Name:UNAVAILABLE
Middle Name:
Last Name:AHSAN-UD-DIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AHSAN
Other - Middle Name:
Other - Last Name:UDDIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:525 E 68TH ST # 103
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:646-962-3442
Mailing Address - Fax:646-962-0265
Practice Address - Street 1:505 E 70TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:646-962-3442
Practice Address - Fax:646-962-0265
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301503524207R00000X
MI4301108487208000000X
NY3129892080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics