Provider Demographics
NPI:1619901113
Name:AHMAD, TARIQ NIAZ (MD)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:NIAZ
Last Name:AHMAD
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 1:170 ROTHER AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212-1536
Mailing Address - Country:US
Mailing Address - Phone:716-695-7040
Mailing Address - Fax:716-646-4611
Practice Address - Street 1:565 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2039
Practice Address - Country:US
Practice Address - Phone:716-826-7000
Practice Address - Fax:716-646-4611
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226999208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00040786OtherRAILROAD MEDICARE
NY0411560OtherIHA
NY02382305Medicaid
NYRB7808Medicare PIN
NY02382305Medicaid
NYDD6177Medicare PIN