Provider Demographics
NPI:1679235337
Name:AHMED, SYED IBAD
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:IBAD
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-3497
Mailing Address - Country:US
Mailing Address - Phone:203-843-1910
Mailing Address - Fax:
Practice Address - Street 1:793 GREEN RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-3497
Practice Address - Country:US
Practice Address - Phone:203-843-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist