Provider Demographics
NPI:1619002904
Name:MOHAMMAD A. AHAD, PHYSICIAN P.C.
Entity Type:Organization
Organization Name:MOHAMMAD A. AHAD, PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ABDUL
Authorized Official - Last Name:AHAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-205-3366
Mailing Address - Street 1:5303 SEABURY ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4443
Mailing Address - Country:US
Mailing Address - Phone:718-205-3366
Mailing Address - Fax:718-205-3369
Practice Address - Street 1:5303 SEABURY ST
Practice Address - Street 2:SUITE #1
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4443
Practice Address - Country:US
Practice Address - Phone:718-205-3366
Practice Address - Fax:718-205-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01443374Medicaid
NY01443374Medicaid