Provider Demographics
NPI:1235948720
Name:AHMADI, LAYLA
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:AHMADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E LONG RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4759
Mailing Address - Country:US
Mailing Address - Phone:812-241-1671
Mailing Address - Fax:
Practice Address - Street 1:IU SCHOOL OF MEDICINE BUSINESS ADDRESS
Practice Address - Street 2:FAIRBANKS HALL, SUITE 6200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:47802-4759
Practice Address - Country:US
Practice Address - Phone:317-274-8157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program