Provider Demographics
NPI:1972826915
Name:AHMED, SYED RIZWAN (MS)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:RIZWAN
Last Name:AHMED
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2030
Mailing Address - Country:US
Mailing Address - Phone:516-437-1478
Mailing Address - Fax:718-960-9909
Practice Address - Street 1:310 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2525
Practice Address - Country:US
Practice Address - Phone:516-326-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051839-1183500000X
MD14191183500000X
NJ28RI02868800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist