Provider Demographics
NPI:1720229412
Name:AHMED, KAMERIA OMER (PA)
Entity Type:Individual
Prefix:MS
First Name:KAMERIA
Middle Name:OMER
Last Name:AHMED
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 METROPOLITAN AVE APT 5A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7412
Mailing Address - Country:US
Mailing Address - Phone:718-892-5237
Mailing Address - Fax:
Practice Address - Street 1:1491 METROPOLITAN AVE APT 5A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7412
Practice Address - Country:US
Practice Address - Phone:718-892-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003911363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical