Provider Demographics
NPI:1043242670
Name:AHMED, JAMIL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 HARRIS HILL RD STE 207
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7470
Mailing Address - Country:US
Mailing Address - Phone:716-634-6448
Mailing Address - Fax:716-634-0987
Practice Address - Street 1:6700 N 1ST ST STE 114
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3947
Practice Address - Country:US
Practice Address - Phone:559-697-4655
Practice Address - Fax:559-827-4869
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224452-1208100000X
CAA90461208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1043242670Medicaid
NY1043242670Medicaid
CAFA124Medicare PIN