Healthcare Provider Details

I. General information

NPI: 1912318940
Provider Name (Legal Business Name): FARHAN AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 03/05/2023
Certification Date: 03/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4979 HARLEM RD
AMHERST NY
14226-2547
US

IV. Provider business mailing address

4979 HARLEM RD
AMHERST NY
14226-2547
US

V. Phone/Fax

Practice location:
  • Phone: 716-923-4380
  • Fax: 716-923-4384
Mailing address:
  • Phone: 716-923-4380
  • Fax: 716-923-4384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number317396
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number79694
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number49669
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number79694
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: