Healthcare Provider Details

I. General information

NPI: 1538091756
Provider Name (Legal Business Name): SAMIA AHMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 PITKIN AVE
BROOKLYN NY
11207-3509
US

IV. Provider business mailing address

9718 80TH ST
OZONE PARK NY
11416-1909
US

V. Phone/Fax

Practice location:
  • Phone: 844-692-4692
  • Fax:
Mailing address:
  • Phone: 917-327-3063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011501
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: