Provider Demographics
NPI:1922422732
Name:AHMED, NOUSHIN SUMMIT (OD)
Entity Type:Individual
Prefix:
First Name:NOUSHIN
Middle Name:SUMMIT
Last Name:AHMED
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 MAGOTHY BEACH RD STE 104
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4467
Practice Address - Country:US
Practice Address - Phone:410-437-6000
Practice Address - Fax:410-437-6001
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist