Provider Demographics
NPI:1538329651
Name:AHMED, SAHAR SALAH (RPT)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:SALAH
Last Name:AHMED
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:DR
Other - First Name:SAHAR
Other - Middle Name:SALAH
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:110 BELAIR ROAD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-0000
Mailing Address - Country:US
Mailing Address - Phone:917-371-2653
Mailing Address - Fax:917-371-2653
Practice Address - Street 1:271 KELLY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6008
Practice Address - Country:US
Practice Address - Phone:718-698-5600
Practice Address - Fax:718-698-5668
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0293051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0293051OtherNY LICENSE