Healthcare Provider Details

I. General information

NPI: 1881940534
Provider Name (Legal Business Name): HOSNE FAHMIDA AHMED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70-17 37TH AVENUE
JACKSON HEIGHTS NY
11372
US

IV. Provider business mailing address

189 BAY 41ST STREET
BROOKLYN NY
11214
US

V. Phone/Fax

Practice location:
  • Phone: 718-565-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF337453-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: