Healthcare Provider Details

I. General information

NPI: 1023843463
Provider Name (Legal Business Name): SYEDA AHMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 30TH AVE FL 2
ASTORIA NY
11102-1530
US

IV. Provider business mailing address

780 HARBINS COVE DR NW
LILBURN GA
30047-5893
US

V. Phone/Fax

Practice location:
  • Phone: 718-569-8601
  • Fax:
Mailing address:
  • Phone: 404-729-1521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP013237
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036978
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: