Provider Demographics
NPI:1871697193
Name:AHMED, ZEHRA (PA)
Entity type:Individual
Prefix:
First Name:ZEHRA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 COLONIAL PL
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1756
Mailing Address - Country:US
Mailing Address - Phone:718-405-8465
Mailing Address - Fax:718-920-2629
Practice Address - Street 1:MMC - DEPT OF NUCLEAR MEDICINE
Practice Address - Street 2:1695A EASTCHESTER ROAD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-405-8465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010187363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant