Provider Demographics
NPI:1356881817
Name:AHMAD DIN, SANA (MD)
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:AHMAD DIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-1123
Mailing Address - Country:US
Mailing Address - Phone:717-851-6500
Mailing Address - Fax:717-755-3435
Practice Address - Street 1:120 HOBART ST
Practice Address - Street 2:RESIDENCY PROGRAM
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4308
Practice Address - Country:US
Practice Address - Phone:315-801-1149
Practice Address - Fax:315-801-3565
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD471664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program