Provider Demographics
NPI:1184692089
Name:AHMED, ANEES (MD)
Entity type:Individual
Prefix:DR
First Name:ANEES
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BANKS RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2324
Mailing Address - Country:US
Mailing Address - Phone:860-651-9970
Mailing Address - Fax:
Practice Address - Street 1:357 E CENTER ST
Practice Address - Street 2:#2
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4472
Practice Address - Country:US
Practice Address - Phone:860-649-1178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0332642084N0400X
CT332642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001332642Medicaid
CTF63541Medicare UPIN
CT260002389Medicare ID - Type Unspecified