Provider Demographics
NPI:1801092986
Name:AHMAD, SALEEM MUHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:SALEEM
Middle Name:MUHAMMED
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SALEEM
Other - Middle Name:M
Other - Last Name:AHMAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6 STILL POND TERRACE
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-1331
Mailing Address - Country:US
Mailing Address - Phone:845-627-2474
Mailing Address - Fax:845-620-0771
Practice Address - Street 1:6 STILL POND TERRACE
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-1331
Practice Address - Country:US
Practice Address - Phone:845-627-2474
Practice Address - Fax:845-620-0771
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1132672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113267OtherNY STATE LICENSE
NY00502130Medicaid
NY113267OtherNYS EDUC DEPT
NY00502130Medicaid
NY113267OtherNYS EDUC DEPT
NY291921Medicare ID - Type Unspecified
NY00502130Medicaid