Provider Demographics
NPI:1477543502
Name:NAZIR, AHSAN (MD)
Entity type:Individual
Prefix:DR
First Name:AHSAN
Middle Name:
Last Name:NAZIR
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 1:18911 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2513
Mailing Address - Country:US
Mailing Address - Phone:516-640-5402
Mailing Address - Fax:
Practice Address - Street 1:18911 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423
Practice Address - Country:US
Practice Address - Phone:718-479-1100
Practice Address - Fax:718-479-1103
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207297207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY207297OtherPHYSICIAN LICENSE