Provider Demographics
NPI:1629255443
Name:AHMED, SARTAJ SULTANA (MD)
Entity Type:Individual
Prefix:
First Name:SARTAJ
Middle Name:SULTANA
Last Name:AHMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3546 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3654
Mailing Address - Country:US
Mailing Address - Phone:814-879-0979
Mailing Address - Fax:814-452-4360
Practice Address - Street 1:3546 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3654
Practice Address - Country:US
Practice Address - Phone:814-879-0979
Practice Address - Fax:814-452-4360
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434791207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology