Provider Demographics
NPI:1457545865
Name:AITEZAZ AHMED, PHYSICIAN, PC
Entity Type:Organization
Organization Name:AITEZAZ AHMED, PHYSICIAN, PC
Other - Org Name:ARTHRITIS CENTER OF ROCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AITEZAZ
Authorized Official - Middle Name:U
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-256-2030
Mailing Address - Street 1:2210 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2419
Mailing Address - Country:US
Mailing Address - Phone:585-256-2030
Mailing Address - Fax:585-256-2037
Practice Address - Street 1:2210 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2419
Practice Address - Country:US
Practice Address - Phone:585-256-2030
Practice Address - Fax:585-256-2037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0580Medicare PIN
NYF39820Medicare UPIN