Provider Demographics
NPI:1740058312
Name:AHMED, KAZI MARIYAH (RN)
Entity type:Individual
Prefix:
First Name:KAZI
Middle Name:MARIYAH
Last Name:AHMED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1851
Mailing Address - Country:US
Mailing Address - Phone:917-557-6591
Mailing Address - Fax:
Practice Address - Street 1:133 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4802
Practice Address - Country:US
Practice Address - Phone:718-606-3863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY904809163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice