Healthcare Provider Details

I. General information

NPI: 1164357083
Provider Name (Legal Business Name): NADER AHMED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6962 188TH ST
FRESH MEADOWS NY
11365-3771
US

IV. Provider business mailing address

6962 188TH ST
FRESH MEADOWS NY
11365-3771
US

V. Phone/Fax

Practice location:
  • Phone: 718-969-2890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074028
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: