Healthcare Provider Details

I. General information

NPI: 1720067341
Provider Name (Legal Business Name): FAIZ AHMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FAIZ AHMAD M.D.

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W 168TH ST PH 137-1
NEW YORK NY
10032-3720
US

IV. Provider business mailing address

622 W 168TH ST PH 137-1
NEW YORK NY
10032-3720
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-9825
  • Fax:
Mailing address:
  • Phone: 212-305-9825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number209014
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: