Provider Demographics
NPI:1740765320
Name:AHMED, TANZINA
Entity Type:Individual
Prefix:
First Name:TANZINA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15916 UNION TPKE STE 325
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1963
Mailing Address - Country:US
Mailing Address - Phone:718-267-5441
Mailing Address - Fax:718-267-5442
Practice Address - Street 1:15916 UNION TPKE STE 325
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1963
Practice Address - Country:US
Practice Address - Phone:718-267-5441
Practice Address - Fax:718-267-5442
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator