Healthcare Provider Details

I. General information

NPI: 1265939805
Provider Name (Legal Business Name): NISHAT TASNIM AHMED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CEDAR ST SE STE 5600 OBSTETRICS AND GYNEOCOLOGY
ALBUQUERQUE NM
87106-4920
US

IV. Provider business mailing address

PO BOX 26666 PRESBYTERIAN HEALTHCARE SERVICE
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-563-6000
  • Fax: 505-563-6060
Mailing address:
  • Phone: 505-272-5580
  • Fax: 505-272-6385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberMD2024-0842
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: