Provider Demographics
NPI:1588617443
Name:WAHID, ZAHID (MD)
Entity Type:Individual
Prefix:
First Name:ZAHID
Middle Name:
Last Name:WAHID
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 1:741 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE KATRINE
Mailing Address - State:NY
Mailing Address - Zip Code:12449-5350
Mailing Address - Country:US
Mailing Address - Phone:845-334-2705
Mailing Address - Fax:845-334-4339
Practice Address - Street 1:396 BROADWAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4652
Practice Address - Country:US
Practice Address - Phone:845-334-2700
Practice Address - Fax:845-334-2898
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01854508Medicaid
G77768Medicare UPIN
91G391Medicare ID - Type Unspecified