Healthcare Provider Details

I. General information

NPI: 1306757372
Provider Name (Legal Business Name): ARHAM IHTESHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6970 GRAND CENTRAL PKWY
FOREST HILLS NY
11375-3949
US

IV. Provider business mailing address

2955 SHELL RD
BROOKLYN NY
11224-3634
US

V. Phone/Fax

Practice location:
  • Phone: 718-263-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number60-P144973-02
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: