Healthcare Provider Details

I. General information

NPI: 1447819198
Provider Name (Legal Business Name): TAHREEM AHMAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date: 01/27/2020
Reactivation Date: 03/03/2020

III. Provider practice location address

900 HERTEL AVE
BUFFALO NY
14216-2611
US

IV. Provider business mailing address

726 EXCHANGE ST STE 710
BUFFALO NY
14210-1464
US

V. Phone/Fax

Practice location:
  • Phone: 716-871-1571
  • Fax:
Mailing address:
  • Phone: 716-852-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number343514
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: