Provider Demographics
NPI:1639794555
Name:ANSARI, UMAIR AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:UMAIR
Middle Name:AHMAD
Last Name:ANSARI
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 1:56-45 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-670-2000
Mailing Address - Fax:631-686-7651
Practice Address - Street 1:56-45 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-2000
Practice Address - Fax:631-686-7651
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2023-06-19
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-01-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program