Provider Demographics
NPI:1881926293
Name:AHMED, MOHAMMED SHIMROSE
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SHIMROSE
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3718
Mailing Address - Country:US
Mailing Address - Phone:516-742-1786
Mailing Address - Fax:
Practice Address - Street 1:1481 LELAND AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-3901
Practice Address - Country:US
Practice Address - Phone:718-823-5330
Practice Address - Fax:718-823-5348
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist