Healthcare Provider Details

I. General information

NPI: 1700905858
Provider Name (Legal Business Name): TARIQ NIAZ AHMAD MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 ROTHER AVE
BUFFALO NY
14212-1536
US

IV. Provider business mailing address

170 ROTHER AVE
BUFFALO NY
14212-1536
US

V. Phone/Fax

Practice location:
  • Phone: 716-649-0887
  • Fax: 716-646-4611
Mailing address:
  • Phone: 716-649-0887
  • Fax: 716-646-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number226999
License Number StateNY

VIII. Authorized Official

Name: DR. TARIQ NIAZ AHMAD
Title or Position: OWNER
Credential: M.D.
Phone: 716-649-0887