Provider Demographics
NPI:1679732507
Name:AHMED, SARA B (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:B
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 1:2905 HYLAN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4653
Mailing Address - Country:US
Mailing Address - Phone:718-351-1212
Mailing Address - Fax:718-351-4114
Practice Address - Street 1:2905 HYLAN BOULEVARD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4653
Practice Address - Country:US
Practice Address - Phone:718-351-1212
Practice Address - Fax:718-351-4114
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258472207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03304794Medicaid
NY03304794Medicaid
NYA400043597Medicare PIN