Healthcare Provider Details

I. General information

NPI: 1851353502
Provider Name (Legal Business Name): AHMED EBEID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 STEINWAY ST
ASTORIA NY
11103-3788
US

IV. Provider business mailing address

2531 STEINWAY ST
ASTORIA NY
11103-3788
US

V. Phone/Fax

Practice location:
  • Phone: 929-463-7104
  • Fax:
Mailing address:
  • Phone: 929-463-7104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD28743
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD28743
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD28743
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD28743
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number28074501
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: