Provider Demographics
NPI:1508146861
Name:AHMED, AYESHA J (PT, MHS)
Entity type:Individual
Prefix:
First Name:AYESHA
Middle Name:J
Last Name:AHMED
Suffix:
Gender:
Credentials:PT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 DOYLE AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1609
Mailing Address - Country:US
Mailing Address - Phone:856-669-8477
Mailing Address - Fax:
Practice Address - Street 1:151 DOYLE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-1609
Practice Address - Country:US
Practice Address - Phone:856-669-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT03282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist