Provider Demographics
NPI:1811306590
Name:AHMED, ALI N (PA)
Entity type:Individual
Prefix:MR
First Name:ALI
Middle Name:N
Last Name:AHMED
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:104 UNION AVENUE
Mailing Address - Street 2:SUITE 804
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1844
Mailing Address - Country:US
Mailing Address - Phone:315-703-5049
Mailing Address - Fax:315-703-5079
Practice Address - Street 1:301 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203
Practice Address - Country:US
Practice Address - Phone:315-448-5111
Practice Address - Fax:315-703-5879
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2023-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY017410-1363AM0700X
NY017410363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical