Provider Demographics
NPI:1891097416
Name:AHMED, IMRANA (DO)
Entity Type:Individual
Prefix:DR
First Name:IMRANA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:IMRANA
Other - Middle Name:
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:515 BELLPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-1711
Mailing Address - Country:US
Mailing Address - Phone:631-227-6600
Mailing Address - Fax:631-286-8290
Practice Address - Street 1:515 BELLPORT AVE
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-1711
Practice Address - Country:US
Practice Address - Phone:631-227-6600
Practice Address - Fax:631-286-8290
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine